Basic Information
| Provider Information | |||||||||
| NPI: | 1750463253 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LAURENS COUNTY HEALTH CARE SYSTEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22725 HIGHWAY 76 E | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293257527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649382843 | ||||||||
| FaxNumber: | 8648339477 | ||||||||
| Practice Location | |||||||||
| Address1: | 22725 HIGHWAY 76 E | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293257527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649382843 | ||||||||
| FaxNumber: | 8648339477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FISCUS | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
| AuthorizedOfficialMiddleName: | BARGER | ||||||||
| AuthorizedOfficialTitleorPosition: | SNF ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8649382843 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MPA, NHA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | NCF-786 | SC | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.