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Contact Information

MARY BLACK HEALTH SYSTEM LLC
1686 SKYLYN DR STE 102
SPARTANBURG, SC29307-1058
 Phone: 864-573-3272
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for MARY BLACK HEALTH SYSTEM LLC

NPI # 1073620654
LBN Legal business name MARY BLACK HEALTH SYSTEM LLC
Authorized official DEBBIE BREWER - (DIRECTOR OF PROVIDER ENROLLMENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/23/2006
Last updated 08/14/2007 - About 19 years ago
Identifiers
SC Medicaid GP2893
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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