Organization
PROFESSIONAL HEALTH SVC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS D HALEY (PRESIDENT)
(864) 505-6747
Entity
Organization
Contact information
Practice address
1007 PENDLETON ST, GREENVILLE, SC 29601-2315
(864) 242-1747
(864) 370-1201
Mailing address
PO BOX 26062, GREENVILLE, SC 29616-1062
(864) 242-1747
(864) 370-1201
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R40622
SC
163WC0400X
Case Management Registered Nurse
R40622
SC
Other
Enumeration date
12/07/2009
Last updated
12/15/2015
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