Organization
SPARTANBURG MEDICAL CENTER
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Other names
Medical Group of the Carolinas - Wound Healing Services
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 701, SPARTANBURG, SC 29303-3098
(864) 560-1650
(864) 560-1655
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
—
SC
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
363A00000X
Physician Assistant
—
SC
363L00000X
Nurse Practitioner
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906866
—
NC
01
—
CN1627
RAILROAD MEDICARE GROUP #
SC
05
—
GP4491
—
SC
05
—
PG9980
—
SC
Enumeration date
08/08/2006
Last updated
07/15/2024
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