MARY BLACK PHYSICIANS GROUP LLC NPI 1457555120

NPI Information

NPI: 1457555120
Provider Name: MARY BLACK PHYSICIANS GROUP LLC
Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
108 W RUTHERFORD ST
LANDRUM, SC
ZIP 29356
Phone: (834) 475-4703
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MARY BLACK PHYSICIANS GROUP LLC is a rural health clinic center in Landrum, SC. MARY BLACK PHYSICIANS GROUP LLC NPI is 1457555120. The provider is registered as an organization entity type.

The provider's business location address is:

108 W RUTHERFORD ST
LANDRUM, SC
ZIP 29356-526
Phone: (834) 475-4703
Fax: (864) 457-2736

The provider's authorized official is V Karen Flinn .
The authorized official title is Vp and has the following contact phone number (214) 473-3773.

The enumeration date for this NPI number is 6/14/2007 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	261QR1300X	Clinic/Center	Rural Health			Yes

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

NPI Synchronization or Removal

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