Blackville Healthcare and Rehab, LLC

Organization Active NPI Skilled Nursing Facility · Blackville, SC

NPI 1477546182 · NPPES record last updated Oct 17, 2019

Key facts

NPI
1477546182
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
NH-755 (SC)
Legal business name
BLACKVILLE HEALTHCARE AND REHAB, LLC
Practice address
1612 Jones Bridge Rd
Blackville, SC 29817-3066
Phone
(803) 284-4313
Fax
(803) 284-1746
NPI assigned
Aug 27, 2005
Organization subpart
No

Authorized official

Name
Haim Cy Pizam
Title
Managing Member
Phone
(407) 454-9096

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NH-755 SC Yes

Addresses

Primary practice location

1612 Jones Bridge Rd
Blackville, SC 29817-3066

Mailing address

1612 Jones Bridge Rd
Blackville, SC 29817-3066
Phone (803) 284-4313

Other identifiers

IdentifierTypeStateIssuer
NCF-1038OtherSCDHEC LIC #

Other providers in Blackville, SC

All providers in Blackville, SC · Skilled Nursing Facility in South Carolina

Sources for this page

Verify at the official NPI Registry.