Provider Demographics
NPI:1134338064
Name:GREENVIEW PRIMECARE LLC
Entity type:Organization
Organization Name:GREENVIEW PRIMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7600
Mailing Address - Street 1:125 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-2752
Mailing Address - Country:US
Mailing Address - Phone:270-586-6004
Mailing Address - Fax:270-586-0604
Practice Address - Street 1:125 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:KY
Practice Address - Zip Code:42134-2752
Practice Address - Country:US
Practice Address - Phone:270-586-6004
Practice Address - Fax:270-586-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========OtherTAX ID
KY00305Medicare PIN