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Organization

GENPSYCH OF SOUTH CAROLINA LLC

Active
Parent organization
GENPSYCH INC
Other names
GenPsych Inc
Organization subpart
Yes

Provider details

NPI number
Legal business name
GENPSYCH INC
Authorized official
DR. HENRY ODUNLAMI (OWNER/MEDICAL DIRECTOR)
(908) 231-0511
Entity
Organization

Contact information

Practice address
2 MEDICAL CT, SUMTER, SC 29150-4760
(803) 774-4020
(803) 774-4025
Mailing address
2 MEDICAL CT, SUMTER, SC 29150-4760
(803) 774-4020
(803) 774-4025

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21075
SC
2084P0800X
Psychiatry Physician
25MA07291000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110BHS
SC
Enumeration date
09/22/2010
Last updated
12/20/2010
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