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NPI Code Detail

MEDICARE: SUMTER VALLEY NURSING AND REHAB CENTER LLC

MEDICARE: SUMTER VALLEY NURSING AND REHAB CENTER 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 FacilityNCF-745SC

General Provider Information

NPI Number : 1205131133
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMTER VALLEY NURSING AND REHAB CENTER LLC
Provider Business Mailing Address
First Line : 1761 PINEWOOD RD
Second Line :
City : SUMTER
State : SC
Zip : 29154-9056
Country : US
Telephone Number :
Fax Number :
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 :
Authorized Official
Title or Position : ADMINISTRATOR
Name : KELLY WEST
Credential :
Telephone Number : 305-864-9191
Provider Enumeration Date : 01/25/2011
Last Update Date : 04/28/2011

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