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Organization

MARY BLACK HEALTH SYSTEM, LLC

Active
Parent organization
MARY BLACK HEALTH SYSTEM, LLC
Other names
Foothills Family Medicine Boiling Springs
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARY BLACK HEALTH SYSTEM, LLC
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization

Contact information

Practice address
2212 OLD FURNACE RD, BOILING SPRINGS, SC 29316-5782
(864) 578-9735
Mailing address
PO BOX 406757, ATLANTA, GA 30384-6757
(864) 253-8063

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP1594
SC
Enumeration date
07/30/2006
Last updated
06/25/2008
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