Organization
SPARTANBURG REGIONAL MEDICAL CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTHCARE
Other names
Regional Psychiatry At Village of Pelham
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTHCARE
Authorized official
JANICE FOWLER (CREDENTIALING)
(864) 560-4475
Entity
Organization
Contact information
Practice address
2755 S HIGHWAY 14, GREER, SC 29650-4902
(864) 560-7517
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-7517
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN1627
RR MEDICARE
SC
05
—
GP1118
—
SC
Enumeration date
07/31/2008
Last updated
07/21/2022
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