Organization Name: | THE GREENVILLE CLINIC |
NPI Number: | 1003844978 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | VANESSA PERKINS (ADMINISTRATIVE ASSISTANT) |
Mailing Address: | 1502 S Colorado St Greenville |
State: | MS US |
Postal Code: | 387037219 |
Phone Number: | 6623329872 |
Fax Number: | 6623329878 |
NPI Enumeration Date: | 06/29/2006 |
NPI Last Update Date: | 02/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Multi-Specialty |
Taxonomy Definition: |