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Organization
WHITE OAK MANOR INC
Active
Organization
WHITE OAK MANOR INC
Active
Other names
White Oak Manor Rock Hill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOE HANEY (VP FINANCE)
(864) 327-1162
Entity
Organization
Contact information
Practice address
1915 EBENEZER RD, ROCK HILL, SC 29732-1013
(803) 366-8155
(803) 366-8158
Mailing address
PO BOX 3347, SPARTANBURG, SC 29304-3347
(803) 366-8155
(803) 366-8158
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-885
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0459NH
—
SC
01
—
5260320001
NSC MEDICARE ID-PTAN
SC
Enumeration date
02/22/2007
Last updated
11/05/2008
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