Healthcare Provider Details

I. General information

NPI: 1679509863
Provider Name (Legal Business Name): OCONEE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 LILA DOYLE DR
SENECA SC
29672-9495
US

IV. Provider business mailing address

298 MEMORIAL DR
SENECA SC
29672-9443
US

V. Phone/Fax

Practice location:
  • Phone: 864-885-7678
  • Fax: 864-885-7293
Mailing address:
  • Phone: 864-885-7147
  • Fax: 864-885-7619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNCF297
License Number StateSC

VIII. Authorized Official

Name: MR. GREG SCARBROUGH
Title or Position: VP FINANCE/CFO
Credential:
Phone: 864-885-7600