NPIMap

Organization Active NPI

Greenville Health Corporation

Doing business as Lifeline

  • Public Health or Welfare Agency
  • Greenville, SC
National Provider Identifier
1417066358
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
GREENVILLE HEALTH CORPORATION
Doing business as
Lifeline
Practice address
1009 Grove Rd
Building C
Greenville, SC 29605-4600
Phone
(864) 255-9300
NPI assigned
Aug 30, 2006
Last updated
Apr 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Authorized official

Name
Polly H. Miller
Title
VP Payor Strategies & Alignment
Phone
(864) 522-2286

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1009 Grove Rd
Building C
Greenville, SC 29605-4600

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6307

Other identifiers 1

IdentifierTypeStateIssuer
DE1178MedicaidSC

Other names 1

  • Lifeline Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Urgent Treatment Center24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Locations

1009 Grove Rd
Bldg C
Greenville, SC 29605
Phone (864) 255-9300

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1417066358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 GROVE RD",
            "address_2": "BUILDING C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054600",
            "telephone_number": "864-255-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "VP PAYOR STRATEGIES & ALIGNMENT",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE1178",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifeline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.