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NPI Code Detail

MEDICARE: LAUREL BAYE HEALTHCARE OF GREENVILLE, LLC

MEDICARE: LAUREL BAYE HEALTHCARE OF GREENVILLE, LLC
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 FacilityNCF754SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831187525
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAUREL BAYE HEALTHCARE OF GREENVILLE, LLC
Provider Business Mailing Address
First Line : 661 RUTHERFORD RD
Second Line :
City : GREENVILLE
State : SC
Zip : 29609-4640
Country : US
Telephone Number : 803-266-3229
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 : 803-266-3229
Fax Number :
Authorized Official
Title or Position : CFO
Name : TOM TILLER
Credential :
Telephone Number : 843-216-6800
Provider Enumeration Date : 10/07/2005
Last Update Date : 06/24/2009

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