Organization
GREENWOOD GENETICS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PRIDMORE (COO)
(864) 941-8100
Entity
Organization
Contact information
Practice address
14 EDGEWOOD DR, GREENVILLE, SC 29605-4246
(864) 250-7944
(864) 250-9582
Mailing address
101 GREGOR MENDEL CIR, GREENWOOD, SC 29646-2316
(864) 388-1072
(864) 388-1052
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
SC
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA2005
—
SC
Enumeration date
04/25/2007
Last updated
07/21/2022
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