Provider Demographics
NPI:1578722633
Name:GREENVILLE SURGERY CENTER LP
Entity Type:Organization
Organization Name:GREENVILLE SURGERY CENTER LP
Other - Org Name:PIEDMONT SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:STILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-380-7557
Mailing Address - Street 1:5 MEMORIAL MEDICAL CT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4449
Mailing Address - Country:US
Mailing Address - Phone:864-380-7557
Mailing Address - Fax:
Practice Address - Street 1:5 MEMORIAL MEDICAL CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4449
Practice Address - Country:US
Practice Address - Phone:864-380-7557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCASF017261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical