Greenville Nursing Center, L.P.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

108484 Issued in TX

Legal business name

GREENVILLE NURSING CENTER, L.P.

Doing business as

Greenville Health & Rehabilitation Center

Practice address

4910 Wellington St.
Greenville, TX 75402-6007

Phone

(903) 454-3772

Fax

(903) 454-3881

NPI assigned

Oct 25, 2005

Last updated

May 29, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Peter J Licari

Title

President of General Partner

Phone

(215) 441-7700

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Greenville Health & Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1144210741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DRYDEN ROAD",
            "address_2": "SUITE 2000",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251048",
            "telephone_number": "215-441-7700",
            "fax_number": "215-441-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 WELLINGTON ST.",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754026007",
            "telephone_number": "903-454-3772",
            "fax_number": "903-454-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE NURSING CENTER, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OF GENERAL PARTNER",
        "authorized_official_telephone_number": "215-441-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "108484",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": "115334",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "115334",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005107",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153004001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004188",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153004002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "153004003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenville Health & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Greenville, TX
• Providers in Greenville, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.