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Organization

GREENWOOD GENETICS CENTER, INC.

Active
Parent organization
GREENWOOD GENETIC CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
GREENWOOD GENETIC CENTER
Authorized official
PAUL PRIDMORE (COO)
(864) 941-8100
Entity
Organization

Contact information

Practice address
1911 THURMOND MALL, COLUMBIA, SC 29201-2375
(803) 799-5390
(803) 799-5391
Mailing address
101 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2316
(864) 388-1072
(864) 388-1052

Taxonomy

Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
SC
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
2080P0006X
Developmental - Behavioral Pediatrics Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA2005
SC
Enumeration date
05/01/2007
Last updated
07/21/2022
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