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General NPI Number Information
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NPI Number | 1104902147
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Entity Type | Organization
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Legal Business Name | SOUTH CAROLINA DEPTARTMENT OF MENTAL HEALTH
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Dates
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Enumeration Date | 10/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 130 HIGHWAY 252
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City | ANDERSON
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State | SC
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Zip | 29621-5054
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Country | US
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Telephone | 864-231-2676
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Fax | 864-231-2747
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Provider Business Mailing Address
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Address Line | PO BOX 2907
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City | ANDERSON
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State | SC
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Zip | 29622-2907
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Country | US
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Telephone | 864-231-2676
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Fax | 864-231-2747
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Authorized Official
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Title or Position | CEO
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Name | MR. JOHN F. FLETCHER
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Credential | MHA
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Telephone | 864-231-2673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 50001955
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License Number State | SC
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