Provider Demographics
NPI:1083916647
Name:USC UPSTATE
Entity Type:Organization
Organization Name:USC UPSTATE
Other - Org Name:HEALTH SERVICES (DEPARTMENT NAME)
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:SAWYER
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-503-5116
Mailing Address - Street 1:800 UNIVERSITY WAY
Mailing Address - Street 2:USC UPSTATE HEALTH SERVICES
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-4932
Mailing Address - Country:US
Mailing Address - Phone:864-503-5000
Mailing Address - Fax:864-503-5099
Practice Address - Street 1:995 UNIVERSITY WAY
Practice Address - Street 2:USC UPSTATE HEALTH SERVICES
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4932
Practice Address - Country:US
Practice Address - Phone:864-503-5000
Practice Address - Fax:864-503-5099
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF SOUTH CAROLINA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-02
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health