MEDICARE: SPARTANBURG SCHOOL DISTRICT TWO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		SC

General Provider Information

NPI Number	:	1285684910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPARTANBURG SCHOOL DISTRICT TWO

Provider Business Mailing Address
First Line	:	4606 PARRIS BRIDGE RD
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316-5916
Country	:	US
Telephone Number	:	864-578-0128
Fax Number	:	864-578-8924

Provider Business Practice Location Address
First Line	:	3231 OLD FURNACE RD
Second Line	:
City	:	CHESNEE
State	:	SC
Zip	:	29323-9653
Country	:	US
Telephone Number	:	864-578-0128
Fax Number	:	864-578-8924

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL SERVICES
Name	:	MR. G. BRANTLEY ENLOE
Credential	:
Telephone Number	:	864-578-0128

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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