MEDICARE: MARY BLACK PHYSICIANS GROUP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215172796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY BLACK PHYSICIANS GROUP, LLC

Provider Business Mailing Address
First Line	:	PO BOX 277827
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30384-7827
Country	:	US
Telephone Number	:	864-253-8080
Fax Number	:	864-582-5188

Provider Business Practice Location Address
First Line	:	2212 OLD FURNACE RD
Second Line	:
City	:	BOILING SPRINGS
State	:	SC
Zip	:	29316-5782
Country	:	US
Telephone Number	:	864-578-9735
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR PROVIDER ENROLLMENT
Name	:	DEBBIE BREWER
Credential	:
Telephone Number	:	615-465-7626

Provider Enumeration Date	:	12/11/2008
Last Update Date	:	12/11/2008

Similar Medicare Providers

1922013721 — MARY BLACK HEALTH SYSTEM, LLC
Practice Location Address:

2212 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-578-9735
Practice Fax:

1124118674 — MR. JAMES RONALD GUIDA RPH
Practice Location Address:

2212 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-599-0889
Practice Fax: 864-599-0824

1760544894 — RON'S PHARMACY, INC.
Practice Location Address:

2212 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-599-0889
Practice Fax: 864-599-0824

1316164551 — MARY BLACK PHYSICIANS GROUP LLC
Practice Location Address:

2212 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-578-9735
Practice Fax: 864-578-7098

1306288667 — DR. ALEKSEY ZELENKO DMD
Practice Location Address:

2224 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-580-8767
Practice Fax:

1427766823 — BLUE RIDGE DENTAL LLC
Practice Location Address:

2224 OLD FURNACE RD
BOILING SPRINGS, SC
29316-5782

Practice Phone: 864-586-5050
Practice Fax:

Directions to “MARY BLACK PHYSICIANS GROUP, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.