Organization
PIEDMONT PSYCHIATRIC SERVICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY GOODBAR M. D. (PHYSICIAN)
(864) 676-9211
Entity
Organization
Contact information
Practice address
2094 WOODRUFF RD, GREENVILLE, SC 29607-5939
(864) 676-9211
(864) 676-9432
Mailing address
2094 WOODRUFF RD, GREENVILLE, SC 29607-5939
(864) 676-9211
(864) 676-9432
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
14711
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2107
—
SC
Enumeration date
03/21/2006
Last updated
02/03/2011
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