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Contact Information

PROVIDENT EAR NOSE AND THROAT LLC
101 S VENTURE DR
GREENVILLE, SC29615-3571
 Phone: 864-232-4846
 Fax: 888-451-9614
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for PROVIDENT EAR NOSE AND THROAT LLC

NPI # 1922236074
LBN Legal business name PROVIDENT EAR NOSE AND THROAT LLC
Authorized official WILLIAM GREENE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/29/2009
Last updated 12/18/2014 - About 11 years ago
Identifiers
SC License # 18523
SC Medicaid T25960
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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