Provider Demographics
NPI:1508819483
Name:SPARTANBURG MEDICAL CENTER
Entity type:Organization
Organization Name:SPARTANBURG MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:864-560-6000
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:151 PEACHWOOD CENTRE DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29301-2575
Practice Address - Country:US
Practice Address - Phone:864-560-9627
Practice Address - Fax:864-560-9686
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-19
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP5864Medicaid
SCGP1118Medicaid
SCCN1627OtherRAILROAD MEDICARE GROUP #
SCGP1118Medicaid