Provider Demographics
NPI:1295266542
Name:INTERIM HEALTHCARE OF GREENVILLE, INC.
Entity type:Organization
Organization Name:INTERIM HEALTHCARE OF GREENVILLE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-627-1200
Mailing Address - Street 1:16 HYLAND ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5756
Mailing Address - Country:US
Mailing Address - Phone:864-627-1200
Mailing Address - Fax:864-627-7102
Practice Address - Street 1:16 HYLAND ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5756
Practice Address - Country:US
Practice Address - Phone:864-627-1200
Practice Address - Fax:864-627-7102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERIM HEALTHCARE OF GREENVILLE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42-7015251E00000X
363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No251E00000XAgenciesHome Health