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NPI Code Detail

MEDICARE: HEALTHCARE PANASCOPE INC.

MEDICARE: HEALTHCARE PANASCOPE INC.
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 FacilityNCF-0918SC

General Provider Information

NPI Number : 1164915666
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHCARE PANASCOPE INC.
Provider Business Mailing Address
First Line : 56 GENESIS DR
Second Line :
City : LAKE CITY
State : SC
Zip : 29560-5531
Country : US
Telephone Number : 843-389-3685
Fax Number : 843-210-3026
Provider Business Practice Location Address
First Line : 56 GENESIS DR
Second Line :
City : LAKE CITY
State : SC
Zip : 29560-5531
Country : US
Telephone Number : 843-389-3685
Fax Number : 843-210-3026
Authorized Official
Title or Position : OWNER
Name : SARAH LISA FRIERSON
Credential :
Telephone Number : 843-389-3685
Provider Enumeration Date : 06/08/2018
Last Update Date : 06/08/2018

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