| Eastside Med Assoc-senior Health | |
|
120 Heywood Ave Spartanburg SC 29302-1210 | |
| (864) 560-3861 | |
| (864) 560-3712 |
| Full Name | Eastside Med Assoc-senior Health |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 120 Heywood Ave, Spartanburg, South Carolina |
| Authorized Official Name and Position | Susan Bruce (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 8645604304 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastside Med Assoc-senior Health Po Box 2168 Spartanburg SC 29304-2168 Ph: (864) 560-4304 | Eastside Med Assoc-senior Health 120 Heywood Ave Spartanburg SC 29302-1210 Ph: (864) 560-3861 |
| NPI Number | 1851332696 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851332696 | NPI | - | NPPES |
| GP1118 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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