Provider Demographics
NPI:1225279755
Name:UNIVERSAL HEALTH CARE GREENVILLE, INC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTH CARE GREENVILLE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-459-2977
Mailing Address - Street 1:301 10TH ST NW STE B-2
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-2419
Mailing Address - Country:US
Mailing Address - Phone:828-464-1817
Mailing Address - Fax:828-464-8137
Practice Address - Street 1:2578 W 5TH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7812
Practice Address - Country:US
Practice Address - Phone:252-758-7100
Practice Address - Fax:252-758-1485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3445181Medicaid
NC3416503Medicaid
NC3416503Medicaid