Provider Demographics
NPI:1053638940
Name:GREATER GREENVILLE FAMILY HEALTH LLC
Entity Type:Organization
Organization Name:GREATER GREENVILLE FAMILY HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARLICIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-608-0884
Mailing Address - Street 1:1754 WOODRUFF RD
Mailing Address - Street 2:303
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5933
Mailing Address - Country:US
Mailing Address - Phone:864-608-0884
Mailing Address - Fax:864-552-1504
Practice Address - Street 1:2086B WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5939
Practice Address - Country:US
Practice Address - Phone:864-608-0884
Practice Address - Fax:864-552-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care