Provider Demographics
NPI:1619902277
Name:NHC HEALTHCARE-GREENWOOD LLC
Entity Type:Organization
Organization Name:NHC HEALTHCARE-GREENWOOD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:B
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:864-226-8356
Mailing Address - Street 1:437 E CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2244
Mailing Address - Country:US
Mailing Address - Phone:864-223-1950
Mailing Address - Fax:
Practice Address - Street 1:437 E CAMBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2244
Practice Address - Country:US
Practice Address - Phone:864-223-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIONAL HEALTHCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-12
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207RG0300X
SCNCF-802314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC400227Medicaid
425063Medicare Oscar/Certification