Organization
MARY BLACK HEALTH SYSTEM LLC
Active
Parent organization
MARY BLACK HEALTH SYSTEM LLC
Other names
Mary Black Health System Spartanburg
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1700 SKYLYN DR, SPARTANBURG, SC 29307-1041
(864) 573-3000
(864) 573-3277
Mailing address
1700 SKYLYN DR, PO BOX 3217, SPARTANBURG, SC 29304
(864) 573-3000
(864) 573-3277
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
HTL-704
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382184
—
SC
05
—
400836
—
SC
Enumeration date
05/18/2006
Last updated
02/22/2018
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