Greenville Health System
Organization Active NPI Rural Health Clinic/Center · Gray Court, SC
NPI 1427440809 · NPPES record last updated Mar 25, 2015
Key facts
- NPI
- 1427440809
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- GREENVILLE HEALTH SYSTEM
- Practice address
- 9100 Highway 14
Gray Court, SC 29645-4152 - Phone
- (864) 876-4888
- Fax
- (864) 876-4900
- NPI assigned
- Feb 23, 2015
- Organization subpart
- No
Authorized official
- Name
- Michael C Riordan
- Title
- President/Ceo
- Phone
- (864) 797-7808
Corporate family (same tax ID) 24
Change of ownership 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Oct 1, 2016 | Change of Ownership |
Prisma Health Laurens Family Med-Gray CT |
National Provider Directory
- Tax ID family
- Upstate Affiliate Org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
9100 Highway 14
Gray Court, SC 29645-4152
Mailing address
1 Independence PT Ste 212
Greenville, SC 29615-4536
Phone (864) 797-6308
Other names
- GHS Laurens Fam Med - Gray Ct
Other providers in Gray Court, SC
- Brynne Gingras
- Cynthia Goode
- Grace Link Transport LLC
- Gray Court Pharmacy
- Joan Williams Greene
- Ann Blair Kennedy
- Samuel Nathan Leake
- Michael Raymond Meeks
- MLC Homecare LLC
- Christopher Todd Nelson
All providers in Gray Court, SC · Rural Health Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.