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General NPI Number Information
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NPI Number | 1962644773
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Entity Type | Organization
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Legal Business Name | PELHAM MEDICAL CENTER
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Dates
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Enumeration Date | 03/26/2009
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 250 WESTMORELAND RD
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City | GREER
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State | SC
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Zip | 29651-9013
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Country | US
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Telephone | 864-530-2108
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Fax | 864-530-2121
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Provider Business Mailing Address
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Address Line | PO BOX 198886
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City | ATLANTA
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State | GA
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Zip | 30384-8886
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Country | US
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Telephone | 864-560-4123
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Fax | 864-560-4023
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Authorized Official
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Title or Position | CFO
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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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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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