MARY BLACK HEALTH SYSTEM LLC NPI 1083640981

NPI Information

NPI: 1083640981
Provider Name: MARY BLACK HEALTH SYSTEM LLC
Classification: Internal Medicine - 207RC0000X
Specialization: Cardiovascular Disease
Entity Type: Organization
Doing Business As: MARY BLACK MEMORIAL HOSPITAL
Address: 1700 SKYLYN DR
SPARTANBURG, SC
ZIP 29307
Phone: (864) 573-3000

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NPI Details

MARY BLACK HEALTH SYSTEM LLC is a cardiovascular disease internal medicine in Spartanburg, SC. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. MARY BLACK HEALTH SYSTEM LLC NPI is 1083640981. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mary Black Memorial Hospital.

The provider's business location address is:

1700 SKYLYN DR
SPARTANBURG, SC
ZIP 29307-041
Phone: (864) 573-3000
Fax: (864) 573-3277

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 6/23/2006 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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	HTL-704	SOUTH CAROLINA	Yes
2	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	HTL-704	SOUTH CAROLINA	X
3	208100000X	Physical Medicine & Rehabilitation				X

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GP1764	MEDICAID	SOUTH 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: 3/30/2025

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