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NPI Code Detail

MEDICARE: SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE

MEDICARE: SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1831338961
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE
Provider Business Mailing Address
First Line : 2414 BULL ST
Second Line : ATTN: TDE GRANT OF TELEPSYCHIATRY
City : COLUMBIA
State : SC
Zip : 29201-1906
Country : US
Telephone Number : 803-898-7183
Fax Number : 803-898-8644
Provider Business Practice Location Address
First Line : 2414 BULL ST
Second Line : ATTN: TDE GRANT OF TELEPSYCHIATRY
City : COLUMBIA
State : SC
Zip : 29201-1906
Country : US
Telephone Number : 803-898-7183
Fax Number : 803-898-8644
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : BRENDA RATLIFF
Credential : M.D.
Telephone Number : 803-898-7183
Provider Enumeration Date : 02/12/2009
Last Update Date : 09/20/2019

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Directions to “SOUTH CAROLINA DEPT OF MENTAL HEALTH ACCOUNTING OFFICE ” Practice Location

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