Organization
GREENWOOD FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JED ALAN GRAHAM M.D. (VP)
(864) 223-6621
Entity
Organization
Contact information
Practice address
1226 SPRING ST, GREENWOOD, SC 29646-3835
(864) 223-6621
(864) 223-6659
Mailing address
1226 SPRING ST, GREENWOOD, SC 29646-3835
(864) 223-6621
(864) 223-6659
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
23953
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184844458
PHARMACY NPI#
SC
01
—
1417972548
NPI
SC
01
—
236953
SC LICENSE#
SC
01
—
4226824
NCPDP#
SC
05
—
7DP004
—
SC
Enumeration date
05/08/2007
Last updated
03/07/2023
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