Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTHCARE
Other names
Medical Group of the Carolinas - Family Medicine - Five Forks
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTHCARE
Authorized official
KENNETH MEINKE (CHIEF FINANCIAL OFFICER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
2801 WOODRUFF RD STE 101, SIMPSONVILLE, SC 29681-4807
(864) 849-9170
(864) 849-9193
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
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN1627
RAILROAD MEDICARE
SC
05
—
GP1118
—
SC
05
—
GP5636
—
SC
Enumeration date
07/31/2008
Last updated
07/18/2019
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