=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538047014
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMINENT HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2025
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 326 ROLLING WATERS DR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29605-6279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-727-6139
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 326 ROLLING WATERS DR
-----------------------------------------------------
City | GREENVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29605-6279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JAMES BOSTICK
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 803-750-5958
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------