Healthcare Provider Details

I. General information

NPI: 1821048661
Provider Name (Legal Business Name): WOODWARD MEDICAL CENTER, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ABERDEEN DR
GREENVILLE SC
29605-2955
US

IV. Provider business mailing address

21 ABERDEEN DR
GREENVILLE SC
29605-2955
US

V. Phone/Fax

Practice location:
  • Phone: 864-242-4122
  • Fax: 864-242-5867
Mailing address:
  • Phone: 864-242-4122
  • Fax: 864-242-5867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH S GROCE
Title or Position: ADMINISTRATOR
Credential:
Phone: 864-370-8321