Healthcare Provider Details

I. General information

NPI: 1972464600
Provider Name (Legal Business Name): GREENVILLE SKIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

306 HIGHWAY 14
SIMPSONVILLE SC
29681-6054
US

IV. Provider business mailing address

306 HIGHWAY 14
SIMPSONVILLE SC
29681-6054
US

V. Phone/Fax

Practice location:
  • Phone: 864-900-4902
  • Fax:
Mailing address:
  • Phone: 864-900-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: INDIA SARAH ROBINSON-PIROTTE
Title or Position: PHYSICIAN, SOLE MEMBER
Credential: MD, MSCR
Phone: 864-900-4902