Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Other names
LePage Surgical Services at Pelham
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
MR. MARK AYCOCK (CHIEF FINANCIAL OFFICIER)
(864) 560-6000
Entity
Organization
Contact information
Practice address
2755 S HIGHWAY 14, HALLWAY 300, GREER, SC 29650-4902
(864) 849-9333
(864) 849-9198
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
—
7628
—
SC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP1118
—
SC
Enumeration date
12/18/2006
Last updated
07/08/2010
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