# GREENWOOD GENETICS CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104013663
- **Authorized official:** PAUL PRIDMORE (COO)
- **Authorized official phone:** (864) 941-8100

## Contact information

- **Practice address:** 3520 W MONTAGUE AVE STE 104, NORTH CHARLESTON, SC 29418-6083
- **Practice address phone:** (843) 746-1001
- **Practice address fax:** (843) 846-1002
- **Mailing address:** 101 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2316
- **Mailing address phone:** (864) 388-1072
- **Mailing address fax:** (864) 388-1052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | NULL | Yes |
| 207SG0201X | Clinical Genetics (M.D.) Physician | — | — | Yes |
| 2080P0006X | Developmental - Behavioral Pediatrics Physician | — | NULL | — |
| 2080P0006X | Developmental - Behavioral Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 09/28/2007
- **Last updated:** 02/10/2022