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General NPI Number Information
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NPI Number | 1437495553
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Entity Type | Organization
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Legal Business Name | GEORGETOWN HC&R NURSING, LLC
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 2715 S ISLAND RD
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City | GEORGETOWN
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State | SC
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Zip | 29440-4415
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Country | US
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Telephone | 843-526-4123
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Fax | 843-527-4465
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Provider Business Mailing Address
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Address Line | 2715 S ISLAND RD
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City | GEORGETOWN
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State | SC
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Zip | 29440-4415
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Country | US
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Telephone | 843-526-4123
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Fax | 843-527-4465
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | BOYD P GENTRY
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Credential |
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Telephone | 678-869-5116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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