Organization
SC DEPARTMENT OF HEALTH & ENVIRONMENTAL CONTROL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHONDA BELLAMY WILSON RN (SUPERVISOR)
(843) 957-5888
Entity
Organization
Contact information
Practice address
2600 BULL ST, COLUMBIA, SC 29201-1708
(843) 546-5593
(843) 546-0456
Mailing address
2600 BULL ST, COLUMBIA, SC 29201-1708
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
313M00000X
SC
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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