Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SSERVICES DISTRICT INC
Other names
Palmetto Pediatric Specialties
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SSERVICES DISTRICT INC
Authorized official
GINA MICHELLE HILLERS (CREDENTIALING SPECIALIST)
(864) 560-4057
Entity
Organization
Contact information
Practice address
2755 S HIGHWAY 14, SUITE 1200H, GREER, SC 29650-4902
(864) 849-9464
(864) 560-4413
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1118
—
SC
Enumeration date
06/30/2006
Last updated
04/20/2008
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