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Organization

MARY BLACK HEALTH SYSTEM LLC

Active
Other names
Womens Health Care Associates
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization

Contact information

Practice address
1686 SKYLYN DR, SUITE 201, SPARTANBURG, SC 29307-1058
(864) 542-1804
(864) 542-9305
Mailing address
1686 SKYLYN DR, SUITE 201, SPARTANBURG, SC 29307-1058
(864) 542-1804
(864) 542-9305

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0456110021
MEDICARE DME PIN
SC
Enumeration date
09/07/2007
Last updated
09/07/2007
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