Provider Demographics
NPI:1871663039
Name:GREENVILLE HOSPITAL
Entity Type:Organization
Organization Name:GREENVILLE HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-521-5920
Mailing Address - Street 1:55 MEADOWLANDS PKWY
Mailing Address - Street 2:2ND FLOOR FINANCE DEPARTMENT
Mailing Address - City:SECAUCUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07094-2977
Mailing Address - Country:US
Mailing Address - Phone:201-770-3709
Mailing Address - Fax:201-770-3750
Practice Address - Street 1:1825 KENNEDY BOULEVARD
Practice Address - Street 2:ECECUTIVE OFFICE
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-2106
Practice Address - Country:US
Practice Address - Phone:201-770-3709
Practice Address - Fax:201-770-3750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10903282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ310105OtherHORIZON BLUE CROSS OF NJ
NJ4140702Medicaid
NJHU0000045-02OtherAMERICHOICE MHS
NJ310105OtherANTHEM GROUP NEW JERSEY
NJ99751OtherAMERIGROUP AMERICAID
NJH05252OtherOXFORD
NH1012309OtherHORIZON NJ HLTHCARE MERCY
NJ1015734OtherHORIZON NJ HLTHCARE MERCY
NJ0013075OtherAETNA US HEALTHCARE
NJ0004311000OtherAMERIHEALTH
NJJ31132OtherHEALTH NET PHS
NJ1015735OtherHORIZON NJ HLTHCARE MERCY
NJ1015736OtherHORIZON NJ HLTHCARE MERCY
NJ4140702OtherCHARITY CARE UNYSIS
NJJ31132OtherHEALTH NET PHS