Healthcare Provider Details

I. General information

NPI: 1063282879
Provider Name (Legal Business Name): RENEW PAIN SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 HALTON VILLAGE CIR STE B
GREENVILLE SC
29607-6832
US

IV. Provider business mailing address

105 HALTON VILLAGE CIR STE B
GREENVILLE SC
29607-6832
US

V. Phone/Fax

Practice location:
  • Phone: 864-456-0126
  • Fax: 864-569-0175
Mailing address:
  • Phone: 864-456-0126
  • Fax: 864-569-0175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILLIP JOSHUA SMITH
Title or Position: OWNER
Credential: MD
Phone: 864-214-5043