Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Other names
Medical Group of theCarolinas - WoundHealingServices-MaryBlackCampus
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) 560-6103
Entity
Organization
Contact information
Practice address
11 DOCTORS PARK DR STE 200, SPARTANBURG, SC 29307-1008
(864) 573-3634
(864) 573-3637
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
—
5019
MEDICARE PTAN
SC
05
—
GP8899
—
SC
05
—
PG9978
—
SC
Enumeration date
02/08/2019
Last updated
12/16/2022
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