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Mary Black Health System, LLC

Organization Active NPI Internal Medicine Physician · Spartanburg, SC

NPI 1316955784 · NPPES record last updated Jun 25, 2008

Key facts

NPI
1316955784
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
MARY BLACK HEALTH SYSTEM, LLC
Practice address
2995 Reidville Rd Ste 210
Spartanburg, SC 29301-5631
Phone
(864) 587-1962
NPI assigned
Aug 3, 2006
Organization subpart
Yes
Parent organization (as reported)
MARY BLACK HEALTH SYSTEM, LLC

Authorized official

Name
Rebecca Hurley
Title
Sr VP
Phone
(214) 473-3993

National Provider Directory

Part of
Mary Black Health System

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X Yes
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

2995 Reidville Rd Ste 210
Spartanburg, SC 29301-5631

Mailing address

PO Box 406757
Atlanta, GA 30384-6757
Phone (864) 253-8080

Other identifiers

IdentifierTypeStateIssuer
GP1611MedicaidSC

Other names

  • Piedmont Internal Medicine Doing business as

Other providers in Spartanburg, SC

All providers in Spartanburg, SC · Internal Medicine Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.