Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Regional Surgical
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
GINA MICHELLE HILLERS (CREDENTIALING SPECIALIST)
(864) 560-4057
Entity
Organization
Contact information
Practice address
100 E WOOD ST, SUITE 301B, SPARTANBURG, SC 29303-3004
(864) 560-1576
(864) 560-4413
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5907999
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
03/19/2007
Last updated
05/08/2009
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