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853 N Church St Suite 410a Spartanburg SC 29303-3098 | |
(864) 560-6928 | |
(864) 560-7329 |
Full Name | |
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Speciality | Internal Medicine - Infectious Disease |
Location | 853 N Church St, Spartanburg, South Carolina |
Authorized Official Name and Position | Kenneth Meinke (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 8645606000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 743070 Atlanta GA 30374-3070 Ph: (864) 560-4057 | 853 N Church St Suite 410a Spartanburg SC 29303-3098 Ph: (864) 560-6928 |
NPI Number | 1639273022 |
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Provider Enumeration Date | 09/07/2006 |
Last Update Date | 12/09/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639273022 | NPI | - | NPPES |
5906123 | Other | NC | NC MEDICAID |
CN1627 | Other | SC | RAILROAD MEDICARE GROUP# |
5906123 | Medicaid | NC | |
GP1118 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RI0200X | Internal Medicine - Infectious Disease | (* (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 | |