Organization
MARY BLACK HEALTH SYSTEM, LLC
Active
Other names
Family Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization
Contact information
Practice address
130 DILLON DR, SPARTANBURG, SC 29307-1018
(864) 585-2027
Mailing address
130 DILLON DR, SPARTANBURG, SC 29307-1018
(864) 585-2027
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1670
—
SC
Enumeration date
07/26/2006
Last updated
05/13/2008
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