| Superior Healthcare Of Spartanburg | |
|
945 E Main St Ste 4 Spartanburg SC 29302-2119 | |
| (864) 586-1284 | |
| (864) 586-1285 |
| Full Name | Superior Healthcare Of Spartanburg |
|---|---|
| Speciality | Clinic/Center |
| Location | 945 E Main St Ste 4, Spartanburg, South Carolina |
| Authorized Official Name and Position | Jeremy Wilson (OWNER) |
| Authorized Official Contact | 8644040433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Superior Healthcare Of Spartanburg 945 E Main St Ste 4 Spartanburg SC 29302-2119 Ph: (864) 586-1284 | Superior Healthcare Of Spartanburg 945 E Main St Ste 4 Spartanburg SC 29302-2119 Ph: (864) 586-1284 |
| NPI Number | 1356926067 |
|---|---|
| Provider Enumeration Date | 03/15/2021 |
| Last Update Date | 02/06/2023 |
| Medicare PECOS PAC ID | 4284034711 |
|---|---|
| Medicare Enrollment ID | O20210621001082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356926067 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Sergei Ivantchev |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366416356 PECOS PAC ID: 6800868134 Enrollment ID: I20160217002081 |
| Provider Name | Pamela M Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952820136 PECOS PAC ID: 2961768122 Enrollment ID: I20171106000110 |
| Provider Name | Ryan Seldon Ford |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558344754 PECOS PAC ID: 9335121631 Enrollment ID: I20220422000950 |
| Provider Name | Brittney Lynn Clemmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083324438 PECOS PAC ID: 5799158432 Enrollment ID: I20230228003030 |
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