| NPI | 1699761908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERWIN WELCH Owner 843-662-4573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SC NCF-450) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: SC 0450nh) |
| 332BN1400X Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies (Licence: SC 0450NH) | |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2007-12-11 |