| Mary Black Health System Spartanburg | |
|
1700 Skylyn Dr Spartanburg SC 29307-1041 | |
| (864) 573-3000 | |
| (864) 573-3277 |
| Full Name | Mary Black Health System Spartanburg |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1700 Skylyn Dr, Spartanburg, South Carolina |
| Authorized Official Name and Position | Paula Lalor (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Contact | 6159254565 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Black Health System Spartanburg 1700 Skylyn Dr Po Box 3217 Spartanburg SC 29304 Ph: (864) 573-3000 | Mary Black Health System Spartanburg 1700 Skylyn Dr Spartanburg SC 29307-1041 Ph: (864) 573-3000 |
| NPI Number | 1992758296 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 02/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992758296 | NPI | - | NPPES |
| 400836 | Medicaid | SC | |
| 382184 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | HTL-704 (South Carolina) | Primary |
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