Healthcare Provider Details

I. General information

NPI: 1518950716
Provider Name (Legal Business Name): THE GREENWOOD ENDOSCOPY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 LINER DR
GREENWOOD SC
29646-2311
US

IV. Provider business mailing address

103 LINER DR
GREENWOOD SC
29646-2311
US

V. Phone/Fax

Practice location:
  • Phone: 864-227-3838
  • Fax: 864-227-6116
Mailing address:
  • Phone: 864-227-3838
  • Fax: 864-227-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License NumberASF022
License Number StateSC

VIII. Authorized Official

Name: MS. APRIL CRISP
Title or Position: OFFICE MANAGER
Credential:
Phone: 864-227-3838