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NPI Code Detail

MEDICARE: SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE

MEDICARE: SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)SC

Other Identifiers

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

General Provider Information

NPI Number : 1245279595
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Provider Business Mailing Address
First Line : 215 N MAGNOLIA ST
Second Line :
City : SUMTER
State : SC
Zip : 29151-1946
Country : US
Telephone Number : 803-775-9364
Fax Number : 803-773-6615
Provider Business Practice Location Address
First Line : 801 N PIKE W
Second Line :
City : SUMTER
State : SC
Zip : 29153-1906
Country : US
Telephone Number : 803-775-9364
Fax Number : 803-773-6615
Authorized Official
Title or Position : CONTROLLER
Name : TRACY L TURNER
Credential :
Telephone Number : 803-898-8503
Provider Enumeration Date : 06/05/2006
Last Update Date : 09/20/2019

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Directions to “SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE ” Practice Location

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