Healthcare Provider Details

I. General information

NPI: 1851320915
Provider Name (Legal Business Name): SANDPIPER REHAB AND NURSING - DELAWARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 ANNA KNAPP BLVD
MOUNT PLEASANT SC
29464-3133
US

IV. Provider business mailing address

1049 ANNA KNAPP BLVD
MOUNT PLEASANT SC
29464-3133
US

V. Phone/Fax

Practice location:
  • Phone: 843-881-3210
  • Fax:
Mailing address:
  • Phone: 843-881-3210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number876
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ERIC HADLEY
Title or Position: COO
Credential: MHA, CNHA, FACHE
Phone: 843-881-3210