| Omega Psychiatric Solutions | |
|
1735 Saint Julian Pl Ste 102 Columbia SC 29204-2402 | |
| (803) 497-9611 | |
| (803) 353-3622 |
| Full Name | Omega Psychiatric Solutions |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1735 Saint Julian Pl Ste 102, Columbia, South Carolina |
| Authorized Official Name and Position | Kim J Gilmore (CO-OWNER) |
| Authorized Official Contact | 8034979611 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omega Psychiatric Solutions 1735 Saint Julian Pl Ste 102 Columbia SC 29204-2402 Ph: (803) 497-9611 | Omega Psychiatric Solutions 1735 Saint Julian Pl Ste 102 Columbia SC 29204-2402 Ph: (803) 497-9611 |
| NPI Number | 1154892099 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 07/15/2020 |
| Certification Date | 07/15/2020 |
| Medicare PECOS PAC ID | 6901138619 |
|---|---|
| Medicare Enrollment ID | O20191030001669 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154892099 | NPI | - | NPPES |
| 1902891294 | Other | SC | NPI |
| 1184810665 | Other | NPI | |
| 1669404950 | Other | SC | NPI |
| Provider Name | Michelle Chavous Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669404950 PECOS PAC ID: 8123074754 Enrollment ID: I20050328000430 |
| Provider Name | Phyllis Marie Bryant Mobley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902891294 PECOS PAC ID: 8527161835 Enrollment ID: I20070307000055 |
| Provider Name | Kim J Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184810665 PECOS PAC ID: 8022187368 Enrollment ID: I20080513000453 |
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