Organization
CHESTERFIELD CONVALESCENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRIA POLYDOROU CPA (VP FINANCE)
(864) 582-8983
Entity
Organization
Contact information
Practice address
1150 STATE RD, CHERAW, SC 29520-2048
(843) 537-2060
Mailing address
PO BOX 5419, SPARTANBURG, SC 29304-5419
(864) 582-8983
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF552
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0552NH
—
SC
Enumeration date
10/10/2006
Last updated
08/22/2020
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