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120 Heywood Ave Suite 200 Spartanburg SC 29302-1210 | |
(864) 560-3800 | |
(864) 560-4413 |
Full Name | |
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Speciality | Family Medicine |
Location | 120 Heywood Ave, Spartanburg, South Carolina |
Authorized Official Name and Position | Gina Michelle Hillers (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 8645604057 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 2168 Spartanburg SC 29304 Ph: (864) 560-4304 | 120 Heywood Ave Suite 200 Spartanburg SC 29302-1210 Ph: (864) 560-3800 |
NPI Number | 1942241781 |
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Provider Enumeration Date | 06/10/2006 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942241781 | NPI | - | NPPES |
GP1118 | Medicaid | SC | |
CN1627 | Other | SC | RAILROAD MEDICARE GROUP # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Academic Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Magnolia St, Spartanburg, SC 29303 Phone: 540-443-7180 | |