Provider Demographics
NPI:1669603247
Name:NEPHROLOGY ASSOCIATES OF GREENVILLE, LLC
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATES OF GREENVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-861-8028
Mailing Address - Street 1:419 THE PKWY
Mailing Address - Street 2:PMB 230
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-4522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16 MILLS AVE
Practice Address - Street 2:SUITE 8
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4070
Practice Address - Country:US
Practice Address - Phone:843-861-8028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty