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Organization
SPARTANBURG MEDICAL CENTER
Active
Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Other names
Medical Group of the Carolinas - Magnolina Plastic Surgery - Spartanbu
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Authorized official
KENNETH MEINKE (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
391 SERPENTINE DR, SUITE 250, SPARTANBURG, SC 29303-3040
(864) 560-6717
(864) 560-7105
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906122
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
07/12/2006
Last updated
12/10/2014
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