Provider Demographics
NPI:1821048661
Name:WOODWARD MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:WOODWARD MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:S
Authorized Official - Last Name:GROCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-370-8321
Mailing Address - Street 1:21 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-2955
Mailing Address - Country:US
Mailing Address - Phone:864-242-4122
Mailing Address - Fax:864-242-5867
Practice Address - Street 1:21 ABERDEEN DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-2955
Practice Address - Country:US
Practice Address - Phone:864-242-4122
Practice Address - Fax:864-242-5867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3055Medicaid
SC6899Medicare ID - Type Unspecified