NPI 1710995105 · live from the CMS NPI Registry
Mary Black Health System, LLC
Durable Medical Equipment & Medical Supplies in Spartanburg, SC. National Provider Identifier 1710995105, active.
NPI record
| NPI | 1710995105 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Durable Medical Equipment & Medical Supplies 332B00000X |
| Practice location | 123 Dillon Dr, Spartanburg, SC 29307 |
| Practice phone | 864-585-8064 |
| Mailing address | 138 Dillon Dr Ste A, Spartanburg, SC 29307 |
| Enumerated | August 3, 2006 |
| Last updated | September 11, 2025 |
| Authorized official | Rebecca Hurley, Senior Vice President |
| Other names | Kiesau Gynecology Associates |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Obstetrics & Gynecology | 207V00000X | — |
| Obstetrics & Gynecology, Gynecology | 207VG0400X | — |
| Obstetrics & Gynecology, Obstetrics | 207VX0000X | — |
| Durable Medical Equipment & Medical Supplies primary | 332B00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.