NPIMap

Organization Active NPI

Greenville Health Corporation

  • Durable Medical Equipment & Medical Supplies
  • Greenville, SC
National Provider Identifier
1609124668
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
GREENVILLE HEALTH CORPORATION
Practice address
200 Patewood Dr
Suite B 170
Greenville, SC 29615-3593
Phone
(864) 454-8340
Fax
(864) 454-8341
NPI assigned
Aug 23, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Polly H. Miller
Title
SVP Finance, Enterprise Contracting
Phone
(864) 522-2286

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210000441 SC DME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company 4789644212 Practice locations: Greenville, SC

National Provider Directory

National Provider Directory
Tax ID family
Urgent Treatment Ctr WH24 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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

200 Patewood Dr
Suite B 170
Greenville, SC 29615-3593

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 455-7000

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
DE3472MedicaidSC
0306710003OtherSCMEDICARE PTAN

Other names 1

NPPES NPI Registry
  • Equipped for Life Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 27, 2024.

{
    "created_epoch": "1345680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1609124668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-455-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PATEWOOD DR",
            "address_2": "SUITE B 170",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153593",
            "telephone_number": "864-454-8340",
            "fax_number": "864-454-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-23",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "SVP FINANCE, ENTERPRISE CONTRACTING",
        "authorized_official_telephone_number": "864-522-2286"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE3472",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0306710003",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Equipped for Life",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Equipped for Life",
            "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 Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.