Thi of South Carolina at Moncks Corner, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

THI OF SOUTH CAROLINA AT MONCKS CORNER, LLC

Practice address

505 S Live Oak Dr
Moncks Corner, SC 29461-3553

Phone

(843) 761-8368

Fax

(843) 761-5874

NPI assigned

Oct 7, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jimmy Johns

Title

President

Phone

(843) 761-8368

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Manor - Moncks Corner Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497842686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390",
            "telephone_number": "410-773-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S LIVE OAK DR",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613553",
            "telephone_number": "843-761-8368",
            "fax_number": "843-761-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THI OF SOUTH CAROLINA AT MONCKS CORNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-761-8368"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Manor - Moncks Corner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Skilled Nursing Facility in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.