Organization
WHITE OAK MANOR INC
Active
Other names
White Oak Manor Spartanburg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JOE HANEY (VP FINANCE)
(864) 327-1162
Entity
Organization
Contact information
Practice address
295 E PEARL ST, SPARTANBURG, SC 29303-3606
(864) 585-0241
(864) 585-8778
Mailing address
PO BOX 3347, SPARTANBURG, SC 29304-3347
(864) 585-0241
(864) 585-8778
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF-889
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0460NH
—
SC
01
—
5288290001
NSC MEDICARE ID-PTAN
SC
Enumeration date
02/21/2007
Last updated
11/05/2008
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