Organization
GREENVILLE HEALTH SYSTEM
Active
Other names
GHS CENTER FOR PEDIATRIC MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C. RIORDAN (PRESIDENT/CEO)
(864) 797-7808
Entity
Organization
Contact information
Practice address
20 MEDICAL RIDGE DR, GREENVILLE, SC 29605-4267
(864) 220-7270
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6400
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
HTL343
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111717
—
SC
05
—
354643
—
SC
05
—
400783
—
SC
01
—
42D0665869
CLIA
SC
01
—
6510325
AETNA ID
SC
01
—
CB9553
MEDICARE RAILROAD
SC
01
—
CD7464
MEDICARE RAILROAD
SC
01
—
CI4624
MEDICARE RAILROAD
SC
05
—
GP2859
—
SC
Enumeration date
04/16/2014
Last updated
10/01/2015
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