Organization
GREENVILLE HEALTH CORPORATION
Active
Other names
Upstate Pharmacy Center for Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
POLLY H. MILLER (VP PAYOR STRATEGIES & ALIGNMENT)
(864) 522-2286
Entity
Organization
Contact information
Practice address
877 W FARIS RD, GREENVILLE, SC 29605-4289
(864) 455-6330
(864) 455-6329
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 455-7000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15530
SC
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149227
PK
—
05
—
715530
—
SC
Enumeration date
12/11/2014
Last updated
04/14/2021
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