Provider Demographics
NPI:1720220668
Name:GREENVILLE FREE MEDICAL CLINIC, INC.
Entity Type:Organization
Organization Name:GREENVILLE FREE MEDICAL CLINIC, INC.
Other - Org Name:NORTHWEST CRESCENT FREE CLINIC, GREER FREE CLINIC, GOLDEN STRIP FREE C
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-232-1470
Mailing Address - Street 1:PO BOX 8993
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29604-8993
Mailing Address - Country:US
Mailing Address - Phone:864-232-1470
Mailing Address - Fax:864-233-4599
Practice Address - Street 1:600 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3204
Practice Address - Country:US
Practice Address - Phone:864-232-1470
Practice Address - Fax:864-233-4599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No251V00000XAgenciesVoluntary or Charitable