Provider Demographics
NPI:1659306215
Name:NHC HEALTHCARE-MAULDIN LLC
Entity Type:Organization
Organization Name:NHC HEALTHCARE-MAULDIN LLC
Other - Org Name:NHC HEALTHCARE, MAULDIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:B
Authorized Official - Last Name:KINNEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:864-662-1452
Mailing Address - Street 1:850 E BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5842
Mailing Address - Country:US
Mailing Address - Phone:864-675-6421
Mailing Address - Fax:
Practice Address - Street 1:850 E BUTLER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5842
Practice Address - Country:US
Practice Address - Phone:864-675-6421
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:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCNCF-796314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0732NFMedicaid
425359Medicare Oscar/Certification