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General NPI Number Information
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NPI Number | 1861148512
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Entity Type | Organization
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Legal Business Name | MILLENNIUM ASC LLC
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Dates
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Enumeration Date | 02/22/2022
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 214 INNOVATION DR
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City | GREENVILLE
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State | SC
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Zip | 29607-5254
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Country | US
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Telephone | 513-952-4792
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Fax |
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Provider Business Mailing Address
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Address Line | 214 INNOVATION DR
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City | GREENVILLE
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State | SC
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Zip | 29607-5254
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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 | SYSTEM DIRECTOR
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Name | KIMBERLY RALSTON
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Credential |
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Telephone | 864-695-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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