Organization
LAUREL BAYE HEALTHCARE OF ORANGEBURG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM TILLER (CFO)
(843) 216-6800
Entity
Organization
Contact information
Practice address
575 STONEWALL JACKSON BLVD, ORANGEBURG, SC 29115-7250
(803) 534-7771
Mailing address
575 STONEWALL JACKSON BLVD, ORANGEBURG, SC 29115-7250
(803) 534-7771
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF- 858
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0858NF
—
SC
Enumeration date
10/07/2005
Last updated
06/24/2009
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