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SPARTANBURG REGIONAL MED CTR NPI 1942241781


NPI Information

NPI: 1942241781
Provider Name: SPARTANBURG REGIONAL MED CTR

Doing Business As: EASTSIDE MEDICAL ASSOCIATES

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
120 HEYWOOD AVE
SUITE 200
SPARTANBURG, SC
ZIP 29302
Phone: (864) 560-3800
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SPARTANBURG REGIONAL MED CTR is a family medicine in Spartanburg, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. SPARTANBURG REGIONAL MED CTR NPI is 1942241781. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Eastside Medical Associates.

The provider's business location address is:

120 HEYWOOD AVE
SUITE 200
SPARTANBURG, SC
ZIP 29302-210
Phone: (864) 560-3800
Fax: (864) 560-4413

The provider's authorized official is Gina Michelle Hillers .
The authorized official title is Credentialing Specialist and has the following contact phone number (864) 560-4057.

The enumeration date for this NPI number is 6/10/2006 and was last updated on 4/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP1118MEDICAIDSOUTH CAROLINA
2=========002OTHERSOUTH CAROLINATRICARE GROUP#
34710MEDICARE PINSOUTH CAROLINA
4=========011MKOTHERNORTH CAROLINABLUE CROSS NC GROUP#
5CN1627OTHERSOUTH CAROLINARAILROAD MEDICARE GROUP #
6=========016OTHERSOUTH CAROLINABCBS GROUP#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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