1447209242 NPI number — GREENVILLE COUNTY SCHOOL DISTRICT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447209242 NPI number — GREENVILLE COUNTY SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREENVILLE COUNTY SCHOOL DISTRICT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447209242
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 ARCADIA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29609-3856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-241-4156
Provider Business Mailing Address Fax Number:
864-241-3310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
205 ARCADIA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29609-3856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-241-4156
Provider Business Practice Location Address Fax Number:
864-241-3310
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RAIDEN
Authorized Official First Name:
CYNTHIAR
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICAID COORDINATOR
Authorized Official Telephone Number:
864-241-4156

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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