Provider Demographics
NPI:1073532081
Name:SPARTANBURG HOSPITAL FOR RESTORATIVE CARE
Entity Type:Organization
Organization Name:SPARTANBURG HOSPITAL FOR RESTORATIVE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-560-3235
Mailing Address - Street 1:389 SERPENTINE DR
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3026
Mailing Address - Country:US
Mailing Address - Phone:864-560-3235
Mailing Address - Fax:864-560-3158
Practice Address - Street 1:389 SERPENTINE DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3026
Practice Address - Country:US
Practice Address - Phone:864-560-3235
Practice Address - Fax:864-560-3158
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-19
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF - 915314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC425384Medicare Oscar/Certification