Organization
REGENESIS ORGANIZATION COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLON HUNTER (CEO)
(864) 582-2817
Entity
Organization
Contact information
Practice address
750 S. CHURCH STREET, SPARTANBURG, SC 29306
(864) 582-2411
(864) 582-7179
Mailing address
P.O. BOX 5158, SPARTANBURG, SC 29304-5158
(864) 582-2817
(864) 582-2829
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC057
—
SC
Enumeration date
09/13/2005
Last updated
05/18/2020
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