Healthcare Provider Details

I. General information

NPI: 1598733487
Provider Name (Legal Business Name): RURAL BUSINESS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 03/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 GENESIS DR
LAKE CITY SC
29560-5531
US

IV. Provider business mailing address

56 GENESIS DR
LAKE CITY SC
29560-5531
US

V. Phone/Fax

Practice location:
  • Phone: 843-389-3685
  • Fax:
Mailing address:
  • Phone: 843-389-3685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0918NF
License Number StateSC

VIII. Authorized Official

Name: SARAH LISA FRIERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 843-389-3685