Organization
GREENVILLE HEALTH SYSTEM
Active
Other names
Diabetes Self Care MGMT Program
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C RIORDAN (PRESIDENT/CEO)
(864) 797-7808
Entity
Organization
Contact information
Practice address
875 W FARIS RD, GREENVILLE, SC 29605-4254
(864) 455-4003
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20026599
SELECT HEALTH IND ID
SC
01
—
5334522
BLUE CROSS
SC
01
—
AETNA
5334522
SC
05
—
DPE050
—
SC
Enumeration date
06/05/2006
Last updated
04/18/2016
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