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NPI Code Detail

MEDICARE: THREE RIVERS MIDLANDS

MEDICARE: THREE RIVERS MIDLANDS
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
1323P00000XPsychiatric Residential Treatment FacilityRTF-0018SC

General Provider Information

NPI Number : 1821524067
Entity Type Code : Organization
Provider Name (Legal Business Name) : THREE RIVERS MIDLANDS
Provider Business Mailing Address
First Line : 200 ERMINE RD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29170-2024
Country : US
Telephone Number : 803-791-9918
Fax Number : 803-926-5934
Provider Business Practice Location Address
First Line : 200 ERMINE RD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29170-2024
Country : US
Telephone Number : 803-791-9918
Fax Number : 803-926-5934
Authorized Official
Title or Position : PHARMACIST IN CHARGE
Name : DR. MICHELLE CRANDALL DANSBY
Credential : PHARMD
Telephone Number : 803-727-1358
Provider Enumeration Date : 05/09/2017
Last Update Date : 05/09/2017

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Directions to “THREE RIVERS MIDLANDS ” Practice Location

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