Organization
PALMETTO LAKE CITY OPERATING LLC
Active
Other names
Lake City Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GOLDSMITH (ADMINISTRATOR)
(843) 389-9201
Entity
Organization
Contact information
Practice address
1940 BOYD RD, SCRANTON, SC 29591-5835
(843) 389-9201
(843) 389-9202
Mailing address
1940 BOYD RD, SCRANTON, SC 29591-5835
(843) 389-9201
(843) 389-9202
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-846
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0928NF
—
SC
Enumeration date
10/24/2006
Last updated
12/30/2014
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