Provider Demographics
NPI:1295216711
Name:GREENVILLE PATHOLOGY, PA
Entity Type:Organization
Organization Name:GREENVILLE PATHOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:AINSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-561-7992
Mailing Address - Street 1:2515 BOWMAN GRAY DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7215
Mailing Address - Country:US
Mailing Address - Phone:252-561-7992
Mailing Address - Fax:252-561-7993
Practice Address - Street 1:2515 BOWMAN GRAY DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7215
Practice Address - Country:US
Practice Address - Phone:252-561-7992
Practice Address - Fax:252-561-7993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENVILLE PATHOLOGY, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory