Provider Demographics
NPI:1992909923
Name:GREENEVILLE RADIOLOGY IMAGING
Entity type:Organization
Organization Name:GREENEVILLE RADIOLOGY IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:F
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-787-7120
Mailing Address - Street 1:1410 TOSCULUM BLVD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745
Mailing Address - Country:US
Mailing Address - Phone:423-787-7120
Mailing Address - Fax:423-787-7121
Practice Address - Street 1:1410 TOSCULUM BLVD
Practice Address - Street 2:SUITE 2000
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-787-7120
Practice Address - Fax:423-787-7121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3815359Medicare ID - Type UnspecifiedGROUP NUMBER