Healthcare Provider Details

I. General information

NPI: 1780127159
Provider Name (Legal Business Name): GREENVILLE HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2016
Last Update Date: 01/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 BOILING SPRINGS RD STE B
BOILING SPRINGS SC
29316-5304
US

IV. Provider business mailing address

PO BOX 527
GREER SC
29652-0527
US

V. Phone/Fax

Practice location:
  • Phone: 864-578-9524
  • Fax: 864-579-9529
Mailing address:
  • Phone: 864-522-1707
  • Fax: 864-522-1727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16923
License Number StateSC

VIII. Authorized Official

Name: STEVE RANCK
Title or Position: DIRECTOR, AMBULATORY PHARMACY,AO
Credential:
Phone: 864-522-1708