Provider Demographics
NPI:1366492118
Name:ANNE MARIA REHAB AND NURSING CTR
Entity Type:Organization
Organization Name:ANNE MARIA REHAB AND NURSING CTR
Other - Org Name:ANNE MARIA, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOTA
Authorized Official - Middle Name:FELTHAM
Authorized Official - Last Name:GINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-278-0011
Mailing Address - Street 1:1200 TALISMAN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-4032
Mailing Address - Country:US
Mailing Address - Phone:803-278-0011
Mailing Address - Fax:803-442-9344
Practice Address - Street 1:1200 TALISMAN DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29841-4032
Practice Address - Country:US
Practice Address - Phone:803-278-0011
Practice Address - Fax:803-442-9344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF721314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCV509P5189OtherVA CONTRACT PROVIDER
SCV543NHMedicaid
SC0543NHMedicaid
SCV509P5189OtherVA CONTRACT PROVIDER
SC0543NHMedicaid