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NPI 1558527416

NPI 1558527416 : SPARTANBURG MEDICAL CENTER : SIMPSONVILLE, SC

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General NPI Number Information
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    NPI Number           |    1558527416
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPARTANBURG MEDICAL CENTER 
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Dates
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    Enumeration Date     |    07/31/2008
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    Last Update Date     |    07/18/2019
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Provider Practice Location Address
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    Address Line         |    2801 WOODRUFF RD STE 101 
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    City                 |    SIMPSONVILLE
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    State                |    SC
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    Zip                  |    29681-4807
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    Country              |    US
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    Telephone            |    864-849-9170
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    Fax                  |    864-849-9193
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Provider Business Mailing Address
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    Address Line         |    PO BOX 743070 
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    City                 |    ATLANTA
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    State                |    GA
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    Zip                  |    30374-3070
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    Country              |    US
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    Telephone            |    864-560-4304
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    Fax                  |    864-560-4413
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Authorized Official
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    Title or Position    |    CHIEF FINANCIAL OFFICER
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    Name                 |     KENNETH  MEINKE 
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    Credential           |    
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    Telephone            |    864-560-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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