Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Regional Pediatrics Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
MARK AYCOCK (EXECUTIVE VICE PRESIDENT)
(864) 560-6000
Entity
Organization
Contact information
Practice address
853 N CHURCH ST, SUITE 401, SPARTANBURG, SC 29303-3098
(864) 560-6287
(864) 560-7091
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP5790
—
SC
Enumeration date
09/28/2011
Last updated
11/15/2011
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