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General NPI Number Information
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NPI Number | 1922436534
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Entity Type | Organization
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Legal Business Name | GREENVILLE WOMENS SERVICES
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Dates
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Enumeration Date | 10/16/2013
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Last Update Date | 11/10/2013
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Provider Practice Location Address
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Address Line | 213 HALTON RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3509
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Country | US
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Telephone | 864-382-4035
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Fax | 864-382-4040
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Provider Business Mailing Address
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Address Line | PO BOX 26451
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City | GREENVILLE
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State | SC
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Zip | 29616-1451
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Country | US
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Telephone | 864-382-4035
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Fax | 864-382-4040
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Authorized Official
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Title or Position | PRESIDENT
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Name | REBECCA KEITH
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Credential | MD
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Telephone | 864-382-4035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 18307
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License Number State | SC
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