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Organization

MARY BLACK HEALTH SYSTEM LLC

Active
Parent organization
MARY BLACK HEALTH SYSTEM LLC
Other names
Center for Industrial Medicine
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARY BLACK HEALTH SYSTEM LLC
Authorized official
LAURIE HOLTSFORD (DIRECTOR OF BUSINESS OFFICE SUPPORT)
(615) 465-7000
Entity
Organization

Contact information

Practice address
138 DILLON DR STE A, SPARTANBURG, SC 29307-1018
(864) 542-8980
(864) 515-9994
Mailing address
2995 REIDVILLE RD, SUITE 100, SPARTANBURG, SC 29301-5628
(864) 587-3030

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
209800000X
Legal Medicine (M.D./D.O.) Physician

Other

Enumeration date
08/03/2006
Last updated
08/21/2007
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