Provider Demographics
NPI:1447209242
Name:GREENVILLE COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GREENVILLE COUNTY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAIDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-241-4156
Mailing Address - Street 1:205 ARCADIA DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3856
Mailing Address - Country:US
Mailing Address - Phone:864-241-4156
Mailing Address - Fax:864-241-3310
Practice Address - Street 1:205 ARCADIA DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3856
Practice Address - Country:US
Practice Address - Phone:864-241-4156
Practice Address - Fax:864-241-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)