NPIMap

Organization Active NPI

Spartanburg Regional Health Services District, Inc.

  • Community/Retail Pharmacy
  • Spartanburg, SC
National Provider Identifier
1982974390
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
13640 Issued in SC
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Practice address
100 E Wood St Ste 101
Spartanburg, SC 29303-3001
Phone
(864) 560-6772
Fax
(864) 560-7026
NPI assigned
Jan 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Timothy Gentilcore, PHARMD
Title
Operations Manager Retail Pharmacy
Phone
(864) 560-9212

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 13640 SC Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

100 E Wood St Ste 101
Spartanburg, SC 29303-3001

Mailing address

100 E Wood St Ste 101
Spartanburg, SC 29303-3001
Phone (864) 560-6772

Other identifiers 3

IdentifierTypeStateIssuer
13640OtherSCSC BOARD OF PHARMACY
2132261OtherPK
713640MedicaidSC

Other names 1

  • SRHS Pharmacy Physician Center - Spartanburg Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Spartanburg Regional Health Services District Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 E Wood St
Ste 101
Spartanburg, SC 29303
Phone (864) 560-6419

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1982974390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WOOD ST STE 101",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033001",
            "telephone_number": "864-560-6772",
            "fax_number": "864-560-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WOOD ST STE 101",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033001",
            "telephone_number": "864-560-6772",
            "fax_number": "864-560-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "GENTILCORE",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER RETAIL PHARMACY",
        "authorized_official_telephone_number": "864-560-9212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "13640",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC BOARD OF PHARMACY",
            "identifier": "13640",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2132261",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "713640",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRHS Pharmacy Physician Center - Spartanburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.