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General NPI Number Information
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NPI Number | 1437174919
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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 | 07/13/2006
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 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 | 803-898-1662
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Fax |
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Provider Business Mailing Address
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Address Line | 2414 BULL ST
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City | COLUMBIA
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State | SC
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Zip | 29201-1906
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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 | DEPUTY DIRECTOR
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Name | VERSIE J BELLAMY
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Credential |
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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 | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | HTL-0515
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License Number State | SC
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