Organization
EDGEWATER GOLF INC
Active
Parent organization
EDGEWATER GOLF INC.
Other names
Green Wolf Transportation
Organization subpart
Yes
Provider details
NPI number
Legal business name
EDGEWATER GOLF INC.
Authorized official
MS. DIANE M SIMMS (PRESIDENT)
(330) 771-4830
Entity
Organization
Contact information
Practice address
2401 FOX AVE SE, MINERVA, OH 44657-9146
(330) 771-4830
(330) 862-2510
Mailing address
2401 FOX AVE SE, MINERVA, OH 44657-9146
(330) 771-4830
(330) 862-2510
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
—
—
Other
Enumeration date
09/02/2020
Last updated
09/02/2020
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