# SUPERIOR HEALTHCARE PHYSICAL MEDICINE OF GREENVILLE INC

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

## Provider details

- **NPI number:** 1194195941
- **Authorized official:** JEREMY WILSON (OWNER)
- **Authorized official phone:** (864) 404-0433

## Contact information

- **Practice address:** 2520 WADE HAMPTON BLVD STE B, GREENVILLE, SC 29615-1178
- **Practice address phone:** (864) 558-8174
- **Mailing address:** 2520 WADE HAMPTON BLVD STE B, GREENVILLE, SC 29615-1178
- **Mailing address phone:** (864) 558-8174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | SC | — |

## Other

- **Enumeration date:** 10/05/2015
- **Last updated:** 06/17/2024