Provider Demographics
NPI:1568592681
Name:SALUDA NURSING CENTER
Entity Type:Organization
Organization Name:SALUDA NURSING CENTER
Other - Org Name:SALUDA COUNTY AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-445-2146
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:SC
Mailing Address - Zip Code:29138-0398
Mailing Address - Country:US
Mailing Address - Phone:864-445-2146
Mailing Address - Fax:864-445-3119
Practice Address - Street 1:581 NEWBERRY HIGHWAY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138
Practice Address - Country:US
Practice Address - Phone:864-445-2146
Practice Address - Fax:864-445-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-265314000000X
SC089341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC450817Medicaid
SC421834Medicaid
SC450817Medicaid
SC421834Medicaid