Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Medical Group of the Carolinas - Palliative Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
BRUCE A DAVIS (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
100 E WOOD ST STE 300A, SPARTANBURG, SC 29303-3059
(864) 560-6012
(864) 560-6013
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5019
MEDICARE PIN
SC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
09/14/2006
Last updated
08/05/2024
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