Organization
GREENFIELD AREA LIFE SQUAD INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MAYNARD (CHIEF)
(937) 981-3394
Entity
Organization
Contact information
Practice address
640 NORTH WASHINGTON ST, GREENFIELD, OH 45123
(937) 981-3394
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000345
ANTHEM BCBS
—
05
—
0270120
—
OH
Enumeration date
03/22/2006
Last updated
04/13/2009
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