| NPI | 1205888260 |
|---|---|
| Doing Business As | C M TUCKER/RODDEY PAVILION |
| Entity Type | Organization |
| Authorized Contact | VERSIE BELLAMY Deputy Director 803-935-5761 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-09-20 |