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NPI Code Detail

MEDICARE: ELISE M. BAILEY

MEDICARE: ELISE M. BAILEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityR101662SC

General Provider Information

NPI Number : 1518093624
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELISE M. BAILEY
Provider Business Mailing Address
First Line : 5 CRYSTAL SPRINGS RD
Second Line : #511
City : GREENVILLE
State : SC
Zip : 29615-3124
Country : US
Telephone Number : 864-298-0522
Fax Number :
Provider Business Practice Location Address
First Line : 661 RUTHERFORD RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29609-4640
Country : US
Telephone Number : 864-232-2442
Fax Number :
Authorized Official
Title or Position : R.N.
Name : MS. ELISE M BAILEY
Credential : R.N.
Telephone Number : 864-298-0522
Provider Enumeration Date : 02/25/2007
Last Update Date : 08/22/2020

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