Organization
GREENVILLE HEALTH SYSTEM
Active
Other names
GHS Roger C Peace - TBI
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C RIORDAN (PRESIDENT/CEO)
(864) 797-7808
Entity
Organization
Contact information
Practice address
100 AUGUSTA ST, GREENVILLE, SC 29601-3504
(864) 455-2600
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1137663
CIGNA
SC
01
—
20018231
SELECT HEALTH
SC
01
—
7202309
AETNA
SC
05
—
GP2654
—
SC
Enumeration date
05/10/2006
Last updated
08/17/2018
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