Organization
MARY BLACK HEALTH SYSTEM, LLC
Active
Other names
Upstate Surgical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HURLEY (SR VP)
(214) 473-3993
Entity
Organization
Contact information
Practice address
1690 SKYLYN DR STE 140, SPARTANBURG, SC 29307-1036
(864) 591-1664
Mailing address
138 DILLON DR STE A, SPARTANBURG, SC 29307-1018
(864) 542-8980
(864) 515-9994
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1597
—
SC
Enumeration date
08/23/2006
Last updated
09/11/2025
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