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MARY BLACK HEALTH SYSTEM LLC NPI 1255346037


NPI Information

NPI: 1255346037
Provider Name: MARY BLACK HEALTH SYSTEM, LLC

Doing Business As: THE DIAGNOSTIC CENTER IMAGING SERVICES

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
2995 REIDVILLE RD
SUITE 130
SPARTANBURG, SC
ZIP 29301
Phone: (864) 587-3020
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MARY BLACK HEALTH SYSTEM, LLC is a diagnostic radiology radiology in Spartanburg, SC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MARY BLACK HEALTH SYSTEM, LLC NPI is 1255346037. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Diagnostic Center Imaging Services.

The provider's business location address is:

2995 REIDVILLE RD
SUITE 130
SPARTANBURG, SC
ZIP 29301-628
Phone: (864) 587-3020

The provider's authorized official is Rebecca Hurley .
The authorized official title is Senior Vice President and has the following contact phone number (214) 473-3993.

The enumeration date for this NPI number is 7/30/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12085R0202XRadiologyDiagnostic RadiologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP1624MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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