# SPARTANBURG MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
- **Other names:** Medical Group of the Carolinas-Pediatrics- Boiling Springs
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265901359
- **Legal business name:** SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
- **Authorized official:** BRUCE A DAVIS (CHIEWF FINANCIAL OFFICER)
- **Authorized official phone:** (864) 560-6000

## Contact information

- **Practice address:** 575 INGLES DR, INMAN, SC 29349-8314
- **Practice address phone:** (864) 342-4090
- **Practice address fax:** (864) 578-7098
- **Mailing address:** PO BOX 743070, ATLANTA, GA 30374-3070
- **Mailing address phone:** (864) 560-4304
- **Mailing address fax:** (864) 560-4413

## Taxonomy

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

## Other

- **Enumeration date:** 11/19/2018
- **Last updated:** 10/07/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 6084 | MEDICARE PIN | SC |
| 05 | — | GP8756 | — | SC |