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General NPI Number Information
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NPI Number | 1184675316
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Entity Type | Organization
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Legal Business Name | SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 8301 FARROW RD
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City | COLUMBIA
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State | SC
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Zip | 29203-3245
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Country | US
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Telephone | 803-898-8405
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 485
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City | COLUMBIA
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State | SC
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Zip | 29202-0485
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Country | US
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Telephone | 803-898-8405
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. VERSIE BELLAMY
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Credential | M.D.
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Telephone | 803-935-5761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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