| Regenesis Organization Community Health Center | |
|
750 S. Church Street Spartanburg SC 29306 | |
| (864) 582-2411 | |
| (864) 582-7179 |
| Full Name | Regenesis Organization Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 750 S. Church Street, Spartanburg, South Carolina |
| Authorized Official Name and Position | Marlon Hunter (CEO) |
| Authorized Official Contact | 8645822817 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenesis Organization Community Health Center P.o. Box 5158 Spartanburg SC 29304-5158 Ph: (864) 582-2817 | Regenesis Organization Community Health Center 750 S. Church Street Spartanburg SC 29306 Ph: (864) 582-2411 |
| NPI Number | 1194710426 |
|---|---|
| Provider Enumeration Date | 09/13/2005 |
| Last Update Date | 05/18/2020 |
| Medicare PECOS PAC ID | 8022928001 |
|---|---|
| Medicare Enrollment ID | O20030630000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194710426 | NPI | - | NPPES |
| FQC057 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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