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BRIGHTWATER RETIREMENT LLC NPI 1407090434


NPI Information

NPI: 1407090434
Provider Name: BRIGHTWATER RETIREMENT, LLC

Other Name: BRIGHTWATER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization
Address:
101 BRIGHTWATER DR
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 903-8300
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BRIGHTWATER RETIREMENT, LLC is a skilled nursing facility in Myrtle Beach, SC. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. BRIGHTWATER RETIREMENT, LLC NPI is 1407090434. The provider is registered as an organization entity type.
The provider Other Name Is Brightwater.

The provider's business location address is:

101 BRIGHTWATER DR
MYRTLE BEACH, SC
ZIP 29579-268
Phone: (843) 903-8300
Fax: (843) 236-1644

The provider's authorized official is Gary Ventola .
The authorized official title is Sr. Vp Of Administration and has the following contact phone number (704) 246-1610.

The enumeration date for this NPI number is 4/21/2009 and was last updated on 1/14/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthNo
2310400000XAssisted Living FacilityCRC-1489SOUTH CAROLINANo
3314000000XSkilled Nursing FacilityNCF-0955SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1425395MEDICARE OSCAR/CERTIFICATIONSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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