Provider Demographics
NPI:1871269480
Name:ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC
Entity Type:Organization
Organization Name:ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:VEARNAIL
Authorized Official - Middle Name:ROWE
Authorized Official - Last Name:HERZOG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-332-7344
Mailing Address - Street 1:300 S WASHINGTON AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38701-4719
Mailing Address - Country:US
Mailing Address - Phone:662-332-7344
Mailing Address - Fax:662-332-7925
Practice Address - Street 1:300 S WASHINGTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MS
Practice Address - Zip Code:38701-4719
Practice Address - Country:US
Practice Address - Phone:662-332-7344
Practice Address - Fax:662-332-7925
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE SPECIALTY HOSPITAL OF GREENVILLE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit