Provider Demographics
NPI:1336994250
Name:STATE OF SOUTH CAROLINA COMPTROLLER GENERAL
Entity Type:Organization
Organization Name:STATE OF SOUTH CAROLINA COMPTROLLER GENERAL
Other - Org Name:VETERAN VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:803-898-5416
Mailing Address - Street 1:1800 SAINT JULIAN PL
Mailing Address - Street 2:STE 305
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-2417
Mailing Address - Country:US
Mailing Address - Phone:803-898-3560
Mailing Address - Fax:
Practice Address - Street 1:1200 E NATIONAL CEMETERY RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-3239
Practice Address - Country:US
Practice Address - Phone:843-432-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF SOUTH CAROLINA COMPTROLLER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility