Organization
GREENVILLE HOSPITAL SYSTEM
Active
Other names
Patewood Medical Campus Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA T. NEWSOM (VP FINANCE/CFO)
(864) 455-8950
Entity
Organization
Contact information
Practice address
200 PATEWOOD DR, SUITE A16, GREENVILLE, SC 29615-3593
(864) 454-2604
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5707057
AETNA
SC
05
—
GP2417
—
SC
Enumeration date
06/06/2006
Last updated
08/17/2018
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