Healthcare Provider Details

I. General information

NPI: 1861168155
Provider Name (Legal Business Name): FOOTHILLS COMMUNITY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2021
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 HILLCREST DR STE E
EASLEY SC
29640-1207
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 864-343-1220
  • Fax: 864-307-8870
Mailing address:
  • Phone: 864-722-0283
  • Fax: 864-306-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

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