Provider Demographics
NPI:1245280429
Name:GREENWOOD HOME RESPIRATORY CARE, INC.
Entity type:Organization
Organization Name:GREENWOOD HOME RESPIRATORY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:JR
Authorized Official - Credentials:CRT/RCP
Authorized Official - Phone:864-993-8300
Mailing Address - Street 1:204 BIRCHTREE DR
Mailing Address - Street 2:PO BOX 56
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-1502
Mailing Address - Country:US
Mailing Address - Phone:864-223-3800
Mailing Address - Fax:864-223-8329
Practice Address - Street 1:204 BIRCHTREE DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-1502
Practice Address - Country:US
Practice Address - Phone:864-223-3800
Practice Address - Fax:864-223-8329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC65004505332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDME844Medicaid
SCDME844Medicaid