Provider Demographics
NPI:1851390553
Name:CITY OF GREENVILLE
Entity type:Organization
Organization Name:CITY OF GREENVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MITCH
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-329-4644
Mailing Address - Street 1:PO BOX 7207
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27835-7207
Mailing Address - Country:US
Mailing Address - Phone:252-329-4449
Mailing Address - Fax:252-329-4165
Practice Address - Street 1:500 S GREEN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1502
Practice Address - Country:US
Practice Address - Phone:252-329-4609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-15
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11713416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC07252OtherBLUE CROSS BLUE SHIELD
NC154387200OtherUS DEPT OF LABOR
NC3406860Medicaid
NC3339854OtherCIGNA HEALTHCARE OF NC
NC3406860Medicaid
NC278128Medicare ID - Type UnspecifiedMEDICARE