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Organization
WHITE OAK MANOR INC
Active
Organization
WHITE OAK MANOR INC
Active
Other names
White Oak Manor Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOE HANEY (VP FINANCE)
(864) 327-1162
Entity
Organization
Contact information
Practice address
9285 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9126
(843) 797-8282
(843) 824-2441
Mailing address
PO BOX 3347, SPARTANBURG, SC 29304-3347
(843) 797-8282
(843) 824-2441
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-892
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0458NH
—
SC
01
—
1598890519
NSC MEDICARE ID-PTAN
SC
Enumeration date
02/22/2007
Last updated
01/07/2014
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