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Organization
MARY BLACK HEALTH SYSTEM, LLC
Active
Organization
MARY BLACK HEALTH SYSTEM, LLC
Active
Parent organization
MARY BLACK HEALTH SYSTEM, LLC
Other names
Peachview Physical Therapy
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK HEALTH SYSTEM, LLC
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
138 DILLON DR STE A, SPARTANBURG, SC 29307-1018
(864) 542-8980
(864) 515-9994
Mailing address
724 HYATT ST STE F, GAFFNEY, SC 29341-2630
(864) 542-8980
Taxonomy
Speciality
Code
Description
License number
State
246Q00000X
Pathology Specialist/Technologist
Primary
—
NULL
246Q00000X
Pathology Specialist/Technologist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
08/01/2006
Last updated
08/14/2007
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