# 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 - Urology - Pelham
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780248211
- **Legal business name:** SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
- **Authorized official:** KENNETH J MEINKE (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (864) 560-6103

## Contact information

- **Practice address:** 2755 S HIGHWAY 14 STE 2050A, GREER, SC 29650-4902
- **Practice address phone:** (864) 253-8055
- **Practice address fax:** (864) 253-8126
- **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 |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/30/2019
- **Last updated:** 06/26/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5019 | MEDICARE PIN | SC |
| 05 | — | GP9009 | — | SC |