Spartanburg Medical Center
Organization Active NPI Hematology & Oncology Physician · Clinton, SC
NPI 1649424151 · NPPES record last updated Jan 7, 2014
Key facts
- NPI
- 1649424151
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- SPARTANBURG MEDICAL CENTER
- Practice address
- 22725 Highway 76 E
Outpatient Center, Third Floor
Clinton, SC 29325-7527 - Phone
- (864) 938-0620
- Fax
- (864) 938-9830
- NPI assigned
- Nov 11, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Authorized official
- Name
- Kenneth Meinke
- Title
- Chief Financial Officer
- Phone
- (864) 560-6000
Other NPIs on the same Medicare enrollment 28
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000129 | SC | Part B Supplier - Clinic/Group Practice | 3072425297 |
Receives reassigned benefits from 806 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Spartanburg, SC; Union, SC; Boiling Springs, SC; Lyman, SC; Greer, SC; Greenville, SC; Gaffney, SC; Duncan, SC… |
National Provider Directory
- Tax ID family
- SRMC Subacute Care Phys
- Part of
- Spartanburg Regional Health Services District Inc
Locations
22725 Highway 76 E
Fl Third
Clinton, SC 29325
Phone (864) 938-0620
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician |
207RH0003X | Yes |
Addresses
Primary practice location
22725 Highway 76 E
Outpatient Center, Third Floor
Clinton, SC 29325-7527
Mailing address
380 Serpentine Dr
Suite 200
Spartanburg, SC 29303-3066
Phone (864) 560-7050
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4991 | Medicaid | SC |
Other names
- Medical Group of the Carolinas - Hematology Oncology - Laurens
Other providers in Clinton, SC
- Linda Fasig Smith
- Michelle Clarice Smith
- South Carolina CTC, LLC
- South Carolina CVS Pharmacy LLC
- South Carolina Department of Juvenile Justice
- Kodee Spearman
- Sarah Hamm Spencer
- Spine and Joint, LLC
- Kayla Danielle Staton
- Kelly Steadman
All providers in Clinton, SC · Hematology & Oncology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.