MARY BLACK HEALTH SYSTEM, LLC (NPI# 1073529699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073529699 |
| Entity Type | Organization |
| Organization Name | MARY BLACK HEALTH SYSTEM, LLC |
| Other Organization Name | SPARTANBURG SURGICAL |
| Practice Address |
1605 Drayton Ave Spartanburg SC 29305 |
| Mailing Address |
138 Dillon Dr Ste A Spartanburg SC 29307-1018 |
| Practice Telephone | 8645850041 |
| Mailing Telephone | 8645428980 |
| Mailing Fax Number | 8645159994 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | REBECCA HURLEY (SR VP) |
| Authorized Official Telephone | 2144733993 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| X | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP1596 | 05 |
| Other Name | Type Code |
|---|---|
| Spartanburg Surgical | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518074194 | Mary Black Health System, LLC | Obstetrics & Gynecology | 1686 Skylyn Dr Ste 101, Spartanburg, SC 29307-1058 | 2006-08-23 |
| 1629087754 | Mary Black Health System, LLC | Durable Medical Equipment & Medical Supplies | 2995 Reidville Rd Ste 260, Spartanburg, SC 29301-5667 | 2006-08-07 |
| 1679582712 | Mary Black Health System, LLC | Obstetrics & Gynecology | 2995 Reidville Rd Ste 290, Spartanburg, SC 29301-5667 | 2006-08-07 |
| 1710995105 | Mary Black Health System, LLC | Obstetrics & Gynecology | 123 Dillon Dr, Spartanburg, SC 29307-1017 | 2006-08-03 |
| 1376551713 | Mary Black Health System, LLC | Urology | 1 Doctors Park Dr, Spartanburg, SC 29307-1021 | 2006-08-03 |
| 1932117389 | Mary Black Health System, LLC | Durable Medical Equipment & Medical Supplies | 245 E Blackstock Rd, Spartanburg, SC 29301-2633 | 2006-08-03 |
| 1871500843 | Mary Black Health System, LLC | Durable Medical Equipment & Medical Supplies | 145b Dillon Dr, Spartanburg, SC 29307-1017 | 2006-08-02 |
| 1528075082 | Mary Black Health System, LLC | Durable Medical Equipment & Medical Supplies | 138 Dillon Dr Ste A, Spartanburg, SC 29307-1018 | 2006-08-01 |
| 1922013721 | Mary Black Health System, LLC | Durable Medical Equipment & Medical Supplies | 2212 Old Furnace Rd, Boiling Springs, SC 29316-5782 | 2006-07-30 |
| 1770506990 | Mary Black Health System, LLC | Family Medicine | 130 Dillon Dr, Spartanburg, SC 29307-1018 | 2006-07-26 |
| Street Address |
1605 DRAYTON AVE |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295263382 | Brittany Nicole Matson | Dietitian, Registered | 105 E Wood Street, Spartanburg, SC 29305 | 2017-06-01 |
| 1104246685 | Robin Lann | Licensed Practical Nurse | 151 E. Wood St, Spartanburg, SC 29305 | 2014-04-23 |
| 1316364706 | Sylvia Hart | Registered Nurse | 151 E. Wood Street, Spartanburg, SC 29305 | 2014-03-24 |
| 1396087250 | Kenya Jackson Farley | Registered Nurse | 151 East Wood Street, Spartanburg, SC 29305 | 2013-03-19 |
| 1063584704 | Linda Thompson Rogers | Registered Nurse | Spartanburg County Health Office-region 2, 151 East Wood Street, Spartanberg, SC 29305-4217 | 2006-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467052530 | Christi Foster | Social Worker | 2250 E Main St, Spartanburg, SC 29307-1419 | 2020-10-28 |
| 1366040024 | Tanesha M Foster | Massage Therapist | 114 Bj Legins St, Spartanburg, SC 29301-2138 | 2020-10-15 |
| 1295332864 | Insight Optical | Technician/Technologist | 451 E Saint John St, Spartanburg, SC 29302-1623 | 2020-10-06 |
| 1033716253 | Proactive Md Tindall Spartanburg Health Center | Family Medicine | 2273 Hayne St., Spartanburg, SC 29301 | 2020-10-01 |
| 1851908511 | Rachael Pratt | Chiropractor | 1463 E Main St Ste A, Spartanburg, SC 29307-2246 | 2020-09-28 |
| 1750995817 | Gracious Transportation Services,llc | Non-emergency Medical Transport (VAN) | 449 W Centennial St, Spartanburg, SC 29303-2767 | 2020-09-04 |
| 1265045322 | Ptvp | Pharmacy | 8007 Warren H Abernathy Hwy, Spartanburg, SC 29301-2449 | 2020-08-28 |
| 1427660794 | Dana Marie Taylor | Counselor | 720 Symmetry Ct, Spartanburg, SC 29316-5673 | 2020-08-18 |
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1255942975 | Meghan Green | Occupational Therapist | 1400 Boiling Springs Rd, Spartanburg, SC 29303-1995 | 2020-08-14 |
| Find all providers in SPARTANBURG | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992339220 | Donald Jason Jolley | Durable Medical Equipment & Medical Supplies | 1413 Wo Ezell Blvd, Spartanburg, SC 29301-1560 | 2020-02-25 |
| 1275011652 | Tri-state Medical Supplies, North Grove | Durable Medical Equipment & Medical Supplies | 1330 Boiling Springs Rd Ste 2900, Spartanburg, SC 29303 | 2018-07-30 |
| 1881118511 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Pine St Ste 32, Spartanburg, SC 29303-3182 | 2017-08-03 |
| 1619490646 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1510 Wo Ezell Blvd, Spartanburg, SC 29301-2616 | 2017-07-21 |
| 1376095620 | Anesthesia Services Associates | Durable Medical Equipment & Medical Supplies | 225 E Blackstock Rd, Spartanburg, SC 29301-2633 | 2016-11-02 |
| 1215375944 | Southeastern Paper Group | Durable Medical Equipment & Medical Supplies | 50 Old Blackstock Rd, Spartanburg, SC 29301-5571 | 2013-06-04 |
| 1699086546 | Peacock Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8147 Warren H Abernathy Hwy, Spartanburg, SC 29301-2451 | 2010-06-25 |
| 1912221664 | Peaock Medical Equipment & Home Health Care LLC | Durable Medical Equipment & Medical Supplies | 550 S Church St Ste 11, Spartanburg, SC 29306-3306 | 2010-03-24 |
| 1750549341 | Miracle Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 275 S Church St, Suite 103, Spartanburg, SC 29306-3417 | 2008-05-30 |
| 1922283308 | David E Byers | Durable Medical Equipment & Medical Supplies | 1413 W O Ezell Blvd, Spartanburg, SC 29301-1560 | 2008-01-04 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29305 |
Please comment or provide details below to improve the information on MARY BLACK HEALTH SYSTEM, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.