Healthcare Provider Details

I. General information

NPI: 1851942346
Provider Name (Legal Business Name): CHEROKEE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 05/04/2020
Certification Date: 05/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 STUARD ST
GAFFNEY SC
29341-1263
US

IV. Provider business mailing address

PO BOX 277723
ATLANTA GA
30384-7723
US

V. Phone/Fax

Practice location:
  • Phone: 864-560-6000
  • Fax:
Mailing address:
  • Phone: 864-560-6000
  • Fax: 864-560-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH MEINKE
Title or Position: PAYER CREDENTIALING SPECIALIST
Credential:
Phone: 864-560-6000