| Greater Greenville Family Health Llc | |
|
2086b Woodruff Rd Greenville SC 29607-5939 | |
| (864) 608-0884 | |
| (864) 552-1504 |
| Full Name | Greater Greenville Family Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2086b Woodruff Rd, Greenville, South Carolina |
| Authorized Official Name and Position | Harlicia F Farley (OWNER) |
| Authorized Official Contact | 8646080884 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Greenville Family Health Llc 1754 Woodruff Rd 303 Greenville SC 29607-5933 Ph: (864) 608-0884 | Greater Greenville Family Health Llc 2086b Woodruff Rd Greenville SC 29607-5939 Ph: (864) 608-0884 |
| NPI Number | 1053638940 |
|---|---|
| Provider Enumeration Date | 04/30/2010 |
| Last Update Date | 05/28/2010 |
| Medicare PECOS PAC ID | 7113050212 |
|---|---|
| Medicare Enrollment ID | O20100726000767 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053638940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Harlicia Ferguson Farley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154381036 PECOS PAC ID: 8325170590 Enrollment ID: I20100723000406 |
| Provider Name | Shavon Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134777543 PECOS PAC ID: 8820320526 Enrollment ID: I20191030001101 |
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