| Upstate Psychiatry, Pa | |
|
27 Memorial Medical Dr Greenville SC 29605-4407 | |
| (864) 295-2221 | |
| (864) 220-6109 |
| Full Name | Upstate Psychiatry, Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 27 Memorial Medical Dr, Greenville, South Carolina |
| Authorized Official Name and Position | Barnwell Rhett Myers (PRESIDENT) |
| Authorized Official Contact | 8642952221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Psychiatry, Pa 27 Memorial Medical Dr Greenville SC 29605-4407 Ph: (864) 295-2221 | Upstate Psychiatry, Pa 27 Memorial Medical Dr Greenville SC 29605-4407 Ph: (864) 295-2221 |
| NPI Number | 1497792592 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 10/11/2007 |
| Medicare PECOS PAC ID | 1557266251 |
|---|---|
| Medicare Enrollment ID | O20031205000065 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497792592 | NPI | - | NPPES |
| GP0913 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jeanne C Morrow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861434078 PECOS PAC ID: 8527958388 Enrollment ID: I20040317000211 |
| Provider Name | Susan M Essich-kruse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194928051 PECOS PAC ID: 5395830905 Enrollment ID: I20070927000464 |
| Provider Name | Mario E Galvarino |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295825370 PECOS PAC ID: 8426199761 Enrollment ID: I20100108000017 |
| Provider Name | Geera N Desai |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184684961 PECOS PAC ID: 6709098114 Enrollment ID: I20101119001067 |
| Provider Name | Barnwell Myers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891746830 PECOS PAC ID: 6709781404 Enrollment ID: I20111101000000 |
| Provider Name | John Ramsey Dodenhoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750449385 PECOS PAC ID: 5294902698 Enrollment ID: I20120126000324 |
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