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General NPI Number Information
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NPI Number | 1356487607
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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 | 01/30/2007
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 220 FAISON DR
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City | COLUMBIA
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State | SC
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Zip | 29203-3210
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Country | US
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Telephone | 803-935-7154
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Fax | 803-935-5627
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Provider Business Mailing Address
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Address Line | 220 FAISON DR
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City | COLUMBIA
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State | SC
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Zip | 29203-3210
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Country | US
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Telephone | 803-935-7154
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Fax | 803-935-5627
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | MRS. CHRISTINE SHARP LATHAM
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Credential | RPH
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Telephone | 803-935-7154
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 50001379
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 1379
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License Number State | SC
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