Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Medical Group of the Carolinas - Psychiatry
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
KENNETH MEINKE (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
391 SERPENTINE DR, SUITE 400, DOCTOR'S CENTER, SPARTANBURG, SC 29303-3096
(864) 560-7517
(864) 560-7520
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89014YV
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
10/11/2006
Last updated
12/09/2014
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