Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
Regional Maternal Fetal Medicine at Women's Pavillion
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
GINA HILLERS (CREDENTIALING SPECIALIST)
(864) 560-4057
Entity
Organization
Contact information
Practice address
1686 SKYLYN DR, SUITE 102, SPARTANBURG, SC 29307-1058
(864) 560-4304
(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
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN1627
RAILROAD MEDICARE GROUP#
SC
05
—
GP1204
—
SC
Enumeration date
10/02/2007
Last updated
10/25/2007
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