Organization
BON SECOURS MEDICAL GROUP GREENVILLE PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILBUR GAY (CFO)
(864) 561-7672
Entity
Organization
Contact information
Practice address
1 SAINT FRANCIS DR, GREENVILLE, SC 29601-3955
(864) 603-6099
Mailing address
1701 MERCY HEALTH PL, CINCINNATI, OH 45237-6147
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
251E00000X
Home Health Agency
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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