Organization
MARY BLACK PHYSICIAN SERVICES, LLC
Active
Parent organization
MARY BLACK PHYSICIANS SERVICES, LLC
Other names
Steadman Hawkins Clinic of the Carolinas
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARY BLACK PHYSICIANS SERVICES, LLC
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7000
Entity
Organization
Contact information
Practice address
1650 SKYLYN DR, SUITE 200, SPARTANBURG, SC 29307-1047
(864) 216-4640
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/22/2007
Last updated
08/13/2008
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