MARY BLACK HEALTH SYSTEM LLC NPI 1861415085

NPI Information

  • NPI: 1861415085
  • Provider Name: MARY BLACK HEALTH SYSTEM LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: SQUIRES POINTE MEDICAL PARK
  • Address: 500 SQUIRES POINTE
    DUNCAN, SC
    ZIP 29334
  • Phone: (864) 433-8980

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NPI Details

MARY BLACK HEALTH SYSTEM LLC is a family medicine in Duncan, 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 1861415085. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Squires Pointe Medical Park.

The provider's business location address is:

500 SQUIRES POINTE
DUNCAN, SC
ZIP 29334
Phone: (864) 433-8980

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 7/26/2006 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15297MEDICARE PINSOUTH CAROLINA
2GP2924MEDICAIDSOUTH 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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