Provider Demographics
NPI:1164472122
Name:HARVEYS NURSING LLC
Entity Type:Organization
Organization Name:HARVEYS NURSING LLC
Other - Org Name:HARVEYS INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:803-278-0011
Mailing Address - Street 1:163 LOVE AND CARE RD
Mailing Address - Street 2:
Mailing Address - City:SIX MILE
Mailing Address - State:SC
Mailing Address - Zip Code:29682-9569
Mailing Address - Country:US
Mailing Address - Phone:864-868-2307
Mailing Address - Fax:864-868-7813
Practice Address - Street 1:163 LOVE AND CARE RD
Practice Address - Street 2:
Practice Address - City:SIX MILE
Practice Address - State:SC
Practice Address - Zip Code:29682-9569
Practice Address - Country:US
Practice Address - Phone:864-868-2307
Practice Address - Fax:864-868-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF580314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0580NHMedicaid
SC425306Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER