Healthcare Provider Details

I. General information

NPI: 1780924100
Provider Name (Legal Business Name): SPARTANBURG MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 MEDICAL CENTER DR
GAFFNEY SC
29340-4823
US

IV. Provider business mailing address

PO BOX 743070
ATLANTA GA
30374-3070
US

V. Phone/Fax

Practice location:
  • Phone: 864-487-7186
  • Fax: 864-487-7246
Mailing address:
  • Phone: 864-560-4304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. KENNETH MEINKE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 864-560-6000