=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841258803
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GEORGETOWN HEALTHCARE & REHAB.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2715 S ISLAND RD
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29440-4415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-546-4123
-----------------------------------------------------
Fax | 843-527-4465
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2715 S ISLAND RD
-----------------------------------------------------
City | GEORGETOWN
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29440-4415
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-546-4123
-----------------------------------------------------
Fax | 843-527-4465
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. SHEILA WRIGHT RABY
-----------------------------------------------------
Credential | NHA
-----------------------------------------------------
Telephone | 843-546-4123
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------