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NPI Code Detail

MEDICARE: PINEWOOD OPCO LLC

MEDICARE: PINEWOOD OPCO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1144969437
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINEWOOD OPCO LLC
Provider Business Mailing Address
First Line : 1761 PINEWOOD RD
Second Line :
City : SUMTER
State : SC
Zip : 29154-9056
Country : US
Telephone Number : 803-481-8591
Fax Number : 803-481-8601
Provider Business Practice Location Address
First Line : 1761 PINEWOOD RD
Second Line :
City : SUMTER
State : SC
Zip : 29154-9056
Country : US
Telephone Number : 803-481-8591
Fax Number : 803-481-8601
Authorized Official
Title or Position : MANAGER/AUTHORIZED SIGNATORY
Name : JOE NEUMAN
Credential :
Telephone Number : 718-916-1443
Provider Enumeration Date : 06/03/2022
Last Update Date : 06/03/2022

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Directions to “PINEWOOD OPCO LLC ” Practice Location

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