Organization
GREENVILLE HOSPITAL SYSTEM
Active
Other names
Patewood Medical Campus Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA T. NEWSOM (CFO, VP FINANCE)
(864) 455-7978
Entity
Organization
Contact information
Practice address
200 PATEWOOD DR, SUITE A20, GREENVILLE, SC 29615-3593
(864) 454-2600
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
ASF-040
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20020144
SELECT HEALTH
SC
01
—
AETNA
5707057
SC
05
—
GP2418
—
SC
Enumeration date
05/11/2006
Last updated
07/02/2012
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