Provider Demographics
NPI:1942960844
Name:PELHAM MEDICAL CENTER
Entity type:Organization
Organization Name:PELHAM MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:864-560-6000
Mailing Address - Street 1:PO BOX 198886
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8886
Mailing Address - Country:US
Mailing Address - Phone:864-604-1235
Mailing Address - Fax:864-560-4023
Practice Address - Street 1:250 WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-9013
Practice Address - Country:US
Practice Address - Phone:864-530-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPARTANBURG REGIONAL HEALTH SERVICES DISTRICT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-20
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPG0796Medicaid
SC9068OtherMEDICARE PIN