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Organization
MARY BLACK HLTH SYS, LLC
Active
Organization
MARY BLACK HLTH SYS, LLC
Active
Parent organization
MARY BLACK HLTH SYS, LLC
Other names
Carolinas Family Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK HLTH SYS, LLC
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization
Contact information
Practice address
1690 SKYLYN DR STE 210, SPARTANBURG, SC 29307-1075
(864) 585-7887
Mailing address
PO BOX 406757, ATLANTA, GA 30384-6757
(864) 253-8080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1630
—
SC
Enumeration date
08/11/2006
Last updated
08/05/2008
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