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Organization

MARY BLACK HEALTH SYSTEM LLC

Active
Parent organization
MARY BLACK HEALTH SYSTEM LLC
Other names
Chesnee Medical Associates
Organization subpart
Yes

Provider details

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

Contact information

Practice address
702 S ALABAMA STREET, CHESNEE, SC 29306
(864) 703-1414
Mailing address
702 S ALABAMA STREET, CHESNEE, SC 29306
(864) 703-1414

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3769
SC
Enumeration date
07/26/2006
Last updated
08/14/2007
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