Provider Demographics
NPI:1558311779
Name:GREENVILLE HEALTH SYSTEM
Entity Type:Organization
Organization Name:GREENVILLE HEALTH SYSTEM
Other - Org Name:GHS HILLCREST MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:T
Authorized Official - Last Name:NEWSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-455-7978
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6307
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:729 SE MAIN ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-3218
Practice Address - Country:US
Practice Address - Phone:864-454-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCHTL-204282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC400373Medicaid
SCCC2538OtherMEDICARE RAILROAD
SC576007683-005OtherBLUE CHOICE
SC8802721OtherCIGNA
SC6510180OtherAETNA
SC340635Medicaid
SC418062Medicaid
SC42D0668492OtherCLIA
SCCC2538OtherMEDICARE RAILROAD
SC340635Medicaid
SC=========-005OtherBCBS
SC400373Medicaid
SC418062Medicaid