Pediatric Associates-East

LBN: Mary Black Physicians Group, Llc
Pediatric Associates-East is an health care organization with primary practice located at 1686 Skylyn Dr Ste 201 , Spartanburg SC 29307-1079. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as the primary health care specialty. Mary Black Physicians Group, Llc can be contacted via phone (864) 582-8135, or through Brewer, Debbie via phone (615) 465-7626.

Contact Information

Primary practice address
1686 Skylyn Dr Ste 201 Spartanburg SC 29307-1079
Phone: (864) 582-8135
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Brewer, Debbie
Phone: (615) 465-7626

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X

Profile Details

NPI number 1205071784
LBN Legal business name Mary Black Physicians Group, Llc
DBA Doing business as Pediatric Associates-East
Authorized official Brewer, Debbie
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 11th, 2008
Last updated Dec 11th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205071784 NPPES
South Carolina MEDICAID GP4779

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