Provider Demographics
NPI:1326288051
Name:VILLAGE HOSPITAL
Entity Type:Organization
Organization Name:VILLAGE HOSPITAL
Other - Org Name:VILLAGE MATERNITY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PAYER ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MELLISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-560-6554
Mailing Address - Street 1:PO BOX 2168
Mailing Address - Street 2:PHYSICIAN BILLING SERVICE
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-2168
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:250 WESTMORELAND RD
Practice Address - Street 2:MATERNITY SERVICES ADMINISTRATION, 2ND FLOOR
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-9013
Practice Address - Country:US
Practice Address - Phone:864-530-2600
Practice Address - Fax:864-530-2121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-20
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5130Medicaid
SC9068Medicare PIN