Provider Demographics
NPI:1073958195
Name:THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI
Entity Type:Organization
Organization Name:THE HEALTH CARE AUTHORITY OF THE CITY OF GREENVILLE - LV STABLER HOSPI
Other - Org Name:REGIONAL MEDICAL CENTER CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:CPA (INACTIVE)
Authorized Official - Phone:334-383-2423
Mailing Address - Street 1:300 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2025
Mailing Address - Country:US
Mailing Address - Phone:334-382-2681
Mailing Address - Fax:334-383-9884
Practice Address - Street 1:125 CHURCH ST
Practice Address - Street 2:
Practice Address - City:GEORGIANA
Practice Address - State:AL
Practice Address - Zip Code:36033-4268
Practice Address - Country:US
Practice Address - Phone:334-376-2963
Practice Address - Fax:334-376-3657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty