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General NPI Number Information
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NPI Number | 1104743707
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Entity Type | Organization
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Legal Business Name | NOVANT HEALTH GREENVILLE PRIMARY CARE CLINICS, LLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/03/2026
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Provider Practice Location Address
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Address Line | 2 BELLA GROVE DR STE 100
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City | GREENVILLE
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State | SC
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Zip | 29607-3459
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Country | US
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Telephone | 864-603-5600
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Fax | 864-603-5601
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Provider Business Mailing Address
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Address Line | PO BOX 604501
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City | CHARLOTTE
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State | NC
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Zip | 28260-4501
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RCS MANAGER
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Name | LEEA JEANINE WALTON
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Credential |
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Telephone | 704-316-6081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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