Network Geriatric Services, Pa | |
103 S Pine St Spartanburg SC 29302-1972 | |
(864) 327-1510 | |
(864) 327-1662 |
Full Name | Network Geriatric Services, Pa |
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Speciality | Family Medicine - Geriatric Medicine |
Location | 103 S Pine St, Spartanburg, South Carolina |
Authorized Official Name and Position | Roy Bradford Whitney (CEO) |
Authorized Official Contact | 8643271510 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Network Geriatric Services, Pa 103 S Pine St Spartanburg SC 29302-1972 Ph: (864) 327-1510 | Network Geriatric Services, Pa 103 S Pine St Spartanburg SC 29302-1972 Ph: (864) 327-1510 |
NPI Number | 1922045103 |
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Provider Enumeration Date | 05/31/2006 |
Last Update Date | 12/22/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922045103 | NPI | - | NPPES |
GP4420 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | 12758 (South Carolina) | Primary |
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