Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Other names
Medical Group of the Carolinas - Urogynecology
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Authorized official
KENNETH J MEINKE (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
11 DOCTORS PARK DR STE 220, SPARTANBURG, SC 29307-1008
(864) 253-8055
(864) 253-8126
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5019
MEDICARE PIN
SC
05
—
PG0310
—
SC
Enumeration date
02/23/2021
Last updated
03/23/2021
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