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General NPI Number Information
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NPI Number | 1467517649
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Entity Type | Organization
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Legal Business Name | SEDGEWOOD MANOR HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 1645 RIDGE RD
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City | HOPKINS
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State | SC
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Zip | 29061-8432
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Country | US
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Telephone | 803-776-3873
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Fax | 803-217-0365
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Provider Business Mailing Address
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Address Line | 1645 RIDGE RD
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City | HOPKINS
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State | SC
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Zip | 29061-8432
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Country | US
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Telephone | 803-776-3873
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | SAVITRI JOHNSON
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Credential |
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Telephone | 863-226-0358
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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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