Green River Medical Equipment Inc.

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

GREEN RIVER MEDICAL EQUIPMENT INC.

Practice address

327 E Broadway St
Campbellsville, KY 42718-2003

Phone

(270) 465-2400

NPI assigned

Jul 11, 2005

Last updated

Jun 6, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ed Baise, RPH

Title

Owner

Phone

(270) 465-2400

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1851399190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 E BROADWAY ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182003",
            "telephone_number": "270-465-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 E BROADWAY ST",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182003",
            "telephone_number": "270-465-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN RIVER MEDICAL EQUIPMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "BAISE",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-465-2400",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "000000070226",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90001041",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Brook Graham
• Sandra Kaye Grant
• Haylee Graves
• Lindsay Graves, MS, CCC-SLP
• Green River Horizons
• Green River Occupational Therapy, LLC
• Gina Green
• Amanda Gail Greer
• Lois Lynita Greer, M.ED., LPCC
• Amanda Gullett, M.S, SLP

• Customized Equipment (DME) in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Customized Equipment (DME) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.