NPIMap

Organization Active NPI

Interim Healthcare of Greenville, Inc.

  • Home Health Agency
  • Greenville, SC
National Provider Identifier
1235181801
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA-057 Issued in SC
Legal business name
INTERIM HEALTHCARE OF GREENVILLE, INC.
Practice address
16 Hyland Rd
Greenville, SC 29615-5756
Phone
(864) 627-1200
Fax
(864) 627-7102
NPI assigned
May 16, 2006
Last updated
Oct 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Authorized official

Name
Mr. Raymond R Schroeder
Title
President
Phone
(864) 627-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA-057 SC Primary

Addresses

Primary practice location

16 Hyland Rd
Greenville, SC 29615-5756

Mailing address

P.O. Box 12243
Greenville, SC 29612-2243
Phone (864) 627-1200

Other identifiers 1

IdentifierTypeStateIssuer
427015MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

424 Hyatt St
Ste A
Gaffney, SC 29341
Phone (864) 487-3401

125 Eagles Nest Dr
Ste C
Seneca, SC 29678
Phone (864) 885-0461

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2018 Change of OwnershipThis provider was the seller Interim Healthcare of the UpstateCCN 427015, SC, NPI 1750897609

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444608000000",
    "number": "1235181801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 12243",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296122243",
            "telephone_number": "864-627-1200",
            "fax_number": "864-627-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 HYLAND RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155756",
            "telephone_number": "864-627-1200",
            "fax_number": "864-627-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIM HEALTHCARE OF GREENVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2015-10-12",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-627-1200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "SC",
            "license": "HHA-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427015",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.