Provider Demographics
NPI:1407558703
Name:GREENVILLE SURGERY CENTER LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:GREENVILLE SURGERY CENTER LIMITED PARTNERSHIP
Other - Org Name:EHA SURGERY CENTER SENECA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-359-9618
Mailing Address - Street 1:322 UNION STATION DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-4547
Mailing Address - Country:US
Mailing Address - Phone:864-986-0085
Mailing Address - Fax:
Practice Address - Street 1:322 UNION STATION DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678
Practice Address - Country:US
Practice Address - Phone:864-360-1830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE HEALTH AMERICA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-20
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical