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MARY BLACK HEALTH SYSTEM LLC NPI 1982612925


NPI Information

NPI: 1982612925
Provider Name: MARY BLACK HEALTH SYSTEM LLC

Doing Business As: WESTSIDE URGENT CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2995 REIDVILLE RD STE 100
SPARTANBURG, SC
ZIP 29301
Phone: (864) 587-3000
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MARY BLACK HEALTH SYSTEM LLC is a family medicine in Spartanburg, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MARY BLACK HEALTH SYSTEM LLC NPI is 1982612925. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Westside Urgent Care.

The provider's business location address is:

2995 REIDVILLE RD STE 100
SPARTANBURG, SC
ZIP 29301-600
Phone: (864) 587-3000
Fax: (864) 587-3019

The provider's authorized official is Debbie T Brewer .
The authorized official title is Director Of Provider Enrollmetn and has the following contact phone number (615) 465-7626.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 6/25/2008.


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
1207R00000XInternal MedicineNo
2208000000XPediatricsNo
3332B00000XDurable Medical Equipment & Medical SuppliesNo
4207Q00000XFamily MedicineYes

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
1GP4384MEDICAIDSOUTH CAROLINA
25286MEDICARE PINSOUTH 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: 11/14/2023

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