NPI Code Details Logo

NPI 1104876465

NPI 1104876465 : GREENVILLE HEALTH SYSTEM : GREENVILLE, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1104876465
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    GREENVILLE HEALTH SYSTEM 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/10/2006
-----------------------------------------------------
    Last Update Date     |    08/17/2018
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    440 ROPER MOUNTAIN RD SUITE C
-----------------------------------------------------
    City                 |    GREENVILLE
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29615-4242
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    864-522-5350
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1 INDEPENDENCE PT SUITE 212
-----------------------------------------------------
    City                 |    GREENVILLE
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29615-4545
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    864-797-6307
-----------------------------------------------------
    Fax                  |    864-797-6198
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PRESIDENT/CEO
-----------------------------------------------------
    Name                 |     MICHAEL C. RIORDAN 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    864-797-7808
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    HHA-020
-----------------------------------------------------
    License Number State |    SC
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.