# MARY BLACK HEALTH SYSTEM LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARY BLACK HEALTH SYSTEM LLC
- **Other names:** Peachview Extended Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1801900865
- **Legal business name:** MARY BLACK HEALTH SYSTEM LLC
- **Authorized official:** DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7000

## Contact information

- **Practice address:** 724 HYATT ST STE D, GAFFNEY, SC 29341-2630
- **Practice address phone:** (864) 489-5001
- **Mailing address:** 138 DILLON DR STE A, SPARTANBURG, SC 29307-1018
- **Mailing address phone:** (864) 542-8980
- **Mailing address fax:** (864) 515-9994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 08/18/2006
- **Last updated:** 08/14/2007