Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Medical Group of the Carolinas - Infectious Disease
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
853 N CHURCH ST, SUITE 410A, SPARTANBURG, SC 29303-3098
(864) 560-6928
(864) 560-7329
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4057
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5906123
NC MEDICAID
NC
05
—
5906123
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP#
SC
05
—
GP1118
—
SC
Enumeration date
09/07/2006
Last updated
12/09/2014
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