Provider Demographics
NPI:1841258803
Name:GEORGETOWN HEALTHCARE & REHAB.
Entity type:Organization
Organization Name:GEORGETOWN HEALTHCARE & REHAB.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:WRIGHT
Authorized Official - Last Name:RABY
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:843-546-4123
Mailing Address - Street 1:2715 S ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-4415
Mailing Address - Country:US
Mailing Address - Phone:843-546-4123
Mailing Address - Fax:843-527-4465
Practice Address - Street 1:2715 S ISLAND RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-4415
Practice Address - Country:US
Practice Address - Phone:843-546-4123
Practice Address - Fax:843-527-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0633NFMedicaid
SC=========OtherBCBS NETWORK CONTRACT
SC0633NFMedicaid