Professional Health SVC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R40622 Issued in SC

Legal business name

PROFESSIONAL HEALTH SVC

Practice address

1007 Pendleton St
Greenville, SC 29601-2315

Phone

(864) 242-1747

Fax

(864) 370-1201

NPI assigned

Dec 7, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Doris D Haley

Title

President

Phone

(864) 505-6747

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450137600000",
    "number": "1609105444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26062",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296161062",
            "telephone_number": "864-242-1747",
            "fax_number": "864-370-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 PENDLETON ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012315",
            "telephone_number": "864-242-1747",
            "fax_number": "864-370-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALTH SVC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-07",
        "last_updated": "2015-12-15",
        "status": "A",
        "authorized_official_last_name": "HALEY",
        "authorized_official_first_name": "DORIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-505-6747",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "R40622",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "SC",
            "license": "R40622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.