| Regenesis Community Health Center | |
|
301 Cresent Ave Spartanburg SC 29306-0000 | |
| (654) 582-2411 | |
| (864) 582-8445 |
| Full Name | Regenesis Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 301 Cresent Ave, 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 Community Health Center Po Box 5158 Spartanburg SC 29304-5158 Ph: () - | Regenesis Community Health Center 301 Cresent Ave Spartanburg SC 29306-0000 Ph: (654) 582-2411 |
| NPI Number | 1548528714 |
|---|---|
| Provider Enumeration Date | 04/25/2012 |
| Last Update Date | 05/18/2020 |
| Medicare PECOS PAC ID | 8022928001 |
|---|---|
| Medicare Enrollment ID | O20120911000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548528714 | NPI | - | NPPES |
| FQC121 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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