Provider Demographics
NPI:1528365046
Name:GREENVILLE HEALTH CORPORATION
Entity Type:Organization
Organization Name:GREENVILLE HEALTH CORPORATION
Other - Org Name:UPSTATE PHARMACY OCONEE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF PHCY, SVC GHC, AO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-522-1708
Mailing Address - Street 1:PO BOX 527
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29652-0527
Mailing Address - Country:US
Mailing Address - Phone:864-522-1707
Mailing Address - Fax:864-522-1727
Practice Address - Street 1:298 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-9443
Practice Address - Country:US
Practice Address - Phone:864-885-7336
Practice Address - Fax:864-885-7337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
SC154183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148522OtherPK
4230203OtherNCPDP PROVIDER IDENTIFICATION NUMBER