NPIMap

Organization Active NPI

Mary Black Health System LLC

Doing business as Mary Black Health System Spartanburg

  • General Acute Care Hospital
  • Spartanburg, SC
National Provider Identifier
1669425963
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
HTL-704 Issued in SC
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Doing business as
Mary Black Health System Spartanburg
Practice address
1700 Skylyn Dr
Spartanburg, SC 29307-1041
Phone
(864) 573-3000
Fax
(864) 573-3277
NPI assigned
May 18, 2006
Last updated
Feb 14, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paula Lalor
Title
Diredtor/Delegated Official
Phone
(615) 925-4565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X HTL-704 SC Primary

Addresses

Primary practice location

1700 Skylyn Dr
Spartanburg, SC 29307-1041

Mailing address

1700 Skylyn Dr
PO Box 3217
Spartanburg, SC 29307-1041
Phone (864) 573-3000

Other identifiers 2

IdentifierTypeStateIssuer
400836MedicaidSC
382184MedicaidSC

Other names 1

  • Mary Black Health System Spartanburg Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518566400000",
    "number": "1669425963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 SKYLYN DR",
            "address_2": "PO BOX 3217",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071041",
            "telephone_number": "864-573-3000",
            "fax_number": "864-573-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SKYLYN DR",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293071041",
            "telephone_number": "864-573-3000",
            "fax_number": "864-573-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY BLACK HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2018-02-14",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIREDTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL-704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "400836",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "382184",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Black Health System Spartanburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.