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General NPI Number Information
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NPI Number | 1679542971
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Entity Type | Organization
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Legal Business Name | GREENVILLE PEDIATRIC SERVICES, INC
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 300 BETHESDA DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7218
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Country | US
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Telephone | 252-752-7141
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Fax | 252-752-0223
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Provider Business Mailing Address
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Address Line | 300 BETHESDA DR
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City | GREENVILLE
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State | NC
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Zip | 27834-7218
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Country | US
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Telephone | 252-752-7141
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Fax | 252-752-0223
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Authorized Official
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Title or Position | MANAGER
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Name | FRANCES MEADOWS
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Credential |
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Telephone | 252-752-7141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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