Provider Demographics
NPI:1023748928
Name:GREENVILLE HEALTH CORPORATION
Entity type:Organization
Organization Name:GREENVILLE HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR-ENROLLMENT AND CVO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-522-8611
Mailing Address - Street 1:1009 GROVE RD BLDG C
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4600
Mailing Address - Country:US
Mailing Address - Phone:864-522-3500
Mailing Address - Fax:864-522-3500
Practice Address - Street 1:1333 TAYLOR ST STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-2923
Practice Address - Country:US
Practice Address - Phone:864-522-3500
Practice Address - Fax:864-522-3549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies