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Organization
SPARTANBURG REGIONAL MED CTR
Active
Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Eastside Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
GINA MICHELLE HILLERS (CREDENTIALING SPECIALIST)
(864) 560-4057
Entity
Organization
Contact information
Practice address
120 HEYWOOD AVE, SUITE 200, SPARTANBURG, SC 29302-1210
(864) 560-3800
(864) 560-4413
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
06/10/2006
Last updated
04/20/2008
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