Provider Type Icon

MARY BLACK HEALTH SYSTEM LLC NPI 1376551713


NPI Information

NPI: 1376551713
Provider Name: MARY BLACK HEALTH SYSTEM, LLC

Doing Business As: BASS UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization
Address:
1 DOCTORS PARK DR
SPARTANBURG, SC
ZIP 29307
Phone: (864) 585-2587
Get Directions

MARY BLACK HEALTH SYSTEM, LLC is an urology in Spartanburg, SC. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. MARY BLACK HEALTH SYSTEM, LLC NPI is 1376551713. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Bass Urology.

The provider's business location address is:

1 DOCTORS PARK DR
SPARTANBURG, SC
ZIP 29307-021
Phone: (864) 585-2587
Fax: (864) 585-2141

The provider's authorized official is Debbie Brewer .
The authorized official title is Director Of Provider Enrollment and has the following contact phone number (615) 465-7000.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 8/14/2007.


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
1208800000XUrologyYes

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
1GP3679MEDICAIDSOUTH CAROLINA
27571MEDICARE ID-TYPE UNSPECIFIED

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.