MEDICARE: MORRELL NURSING 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
1	314000000X	Skilled Nursing Facility	0881NF	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467447797
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORRELL NURSING CENTER LLC

Provider Business Mailing Address
First Line	:	116 CASHUA ST
Second Line	:
City	:	DARLINGTON
State	:	SC
Zip	:	29532-3202
Country	:	US
Telephone Number	:	843-393-9925
Fax Number	:	843-393-6778

Provider Business Practice Location Address
First Line	:	900 N MARQUIS HWY
Second Line	:
City	:	HARTSVILLE
State	:	SC
Zip	:	29550-3526
Country	:	US
Telephone Number	:	843-383-5164
Fax Number	:	843-383-9072

Authorized Official
Title or Position	:	CEO
Name	:	DENNIS LOFE
Credential	:
Telephone Number	:	843-393-9925

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	02/23/2010

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