MEDICARE: GREENVILLE PARTNERSHIP LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		FL

General Provider Information

NPI Number	:	1639170319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENVILLE PARTNERSHIP LTD

Provider Business Mailing Address
First Line	:	2851 REMINGTON GREEN CIR
Second Line	:	SUITE D
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-1505
Country	:	US
Telephone Number	:	850-386-2522
Fax Number	:	850-386-1552

Provider Business Practice Location Address
First Line	:	HIGHWAY 90 EAST
Second Line	:
City	:	GREENVILLE
State	:	FL
Zip	:	32331
Country	:	US
Telephone Number	:	850-948-4601
Fax Number	:	850-948-1702

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOSEPH D. MITCHELL
Credential	:
Telephone Number	:	850-386-2522

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	01/08/2008

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Directions to “GREENVILLE PARTNERSHIP LTD ” Practice Location

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