Provider Demographics
NPI:1154698850
Name:GREENWOOD FAMILY CARE A.S.A.P. LLC
Entity type:Organization
Organization Name:GREENWOOD FAMILY CARE A.S.A.P. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:VIDYA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-979-2388
Mailing Address - Street 1:134 N EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-9760
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:317-888-4706
Practice Address - Street 1:1680 STONEGATE DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-5013
Practice Address - Country:US
Practice Address - Phone:317-215-4367
Practice Address - Fax:317-888-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-23
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026487A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty