Healthcare Provider Details

I. General information

NPI: 1629770532
Provider Name (Legal Business Name): FOOTHILLS COMMUNITY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 LIBERTY DR STE 200
CLEMSON SC
29631-3159
US

IV. Provider business mailing address

302 PEARMAN DAIRY RD STE C1
ANDERSON SC
29625-3802
US

V. Phone/Fax

Practice location:
  • Phone: 864-633-5171
  • Fax: 864-261-8130
Mailing address:
  • Phone: 864-633-5171
  • Fax: 864-306-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARK JOHN RAJKOWSKI
Title or Position: CEO
Credential:
Phone: 864-722-0283