=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821214529
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONAL HEALTHCARE, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1305 BOILING SPRINGS RD
-----------------------------------------------------
City | GREER
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-458-7566
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 215 WEAVER LN
-----------------------------------------------------
City | SIMPSONVILLE
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29681-5127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 864-234-2951
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICAL THERAPIST ASSISTANT
-----------------------------------------------------
Name | MISS MELODY K LANDIS
-----------------------------------------------------
Credential | PTA
-----------------------------------------------------
Telephone | 864-234-2951
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 2065
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------