Provider Demographics
NPI:1831341866
Name:GREENVILLE MEDICAL CARE PA
Entity type:Organization
Organization Name:GREENVILLE MEDICAL CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCCREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-757-0004
Mailing Address - Street 1:402 S MEMORIAL DR
Mailing Address - Street 2:PO BOX 8265
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-1681
Mailing Address - Country:US
Mailing Address - Phone:252-757-0004
Mailing Address - Fax:252-757-0095
Practice Address - Street 1:402 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-1681
Practice Address - Country:US
Practice Address - Phone:252-757-0004
Practice Address - Fax:252-757-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty