Provider Demographics
NPI:1003265109
Name:SYNERGY HEALTH SYSTEMS
Entity type:Organization
Organization Name:SYNERGY HEALTH SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WHITTENEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-609-8614
Mailing Address - Street 1:916 FIVE CHOP RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-6315
Mailing Address - Country:US
Mailing Address - Phone:757-487-2803
Mailing Address - Fax:757-487-2968
Practice Address - Street 1:1602 CAVALIER BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3808
Practice Address - Country:US
Practice Address - Phone:757-487-2803
Practice Address - Fax:757-487-2968
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYNERGY HEALTH SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-09
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC251S00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health