# SPARTANBURG REGIONAL MED CTR

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPARTANBURG REGIONAL HEALTH SSERVICES DISTRICT INC
- **Other names:** Palmetto Pediatric Specialties
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184652794
- **Legal business name:** SPARTANBURG REGIONAL HEALTH SSERVICES DISTRICT INC
- **Authorized official:** GINA MICHELLE HILLERS (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (864) 560-4057

## Contact information

- **Practice address:** 2755 S HIGHWAY 14, SUITE 1200H, GREER, SC 29650-4902
- **Practice address phone:** (864) 849-9464
- **Practice address fax:** (864) 560-4413
- **Mailing address:** PO BOX 2168, SPARTANBURG, SC 29304
- **Mailing address phone:** (864) 560-4304
- **Mailing address fax:** (864) 560-4413

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP1118 | — | SC |