Provider Demographics
NPI:1750311767
Name:GREENVILLE PHYSCIANS IMAGING CENTER
Entity Type:Organization
Organization Name:GREENVILLE PHYSCIANS IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:J
Authorized Official - Last Name:KAROLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-627-0500
Mailing Address - Street 1:103 S VENTURE DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3571
Mailing Address - Country:US
Mailing Address - Phone:864-627-0500
Mailing Address - Fax:864-627-8655
Practice Address - Street 1:103 S VENTURE DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3571
Practice Address - Country:US
Practice Address - Phone:864-627-0500
Practice Address - Fax:864-627-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1715Medicaid
SC5010Medicare ID - Type UnspecifiedFACILITY #