Healthcare Provider Details

I. General information

NPI: 1952351249
Provider Name (Legal Business Name): GREENVILLE HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AUGUSTA ST
GREENVILLE SC
29601-3504
US

IV. Provider business mailing address

1 INDEPENDENCE PT SUITE 212
GREENVILLE SC
29615-4545
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-2600
  • Fax:
Mailing address:
  • Phone: 864-797-6307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C RIORDAN
Title or Position: PRESIDENT/CEO
Credential:
Phone: 864-797-7808