Healthcare Provider Details

I. General information

NPI: 1699123026
Provider Name (Legal Business Name): REGIONAL HEALTH & TESTING CENTER L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2016
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

376 W PALMETTO ST
FLORENCE SC
29501-4418
US

IV. Provider business mailing address

376 W PALMETTO ST
FLORENCE SC
29501-4418
US

V. Phone/Fax

Practice location:
  • Phone: 843-699-0675
  • Fax: 843-758-0933
Mailing address:
  • Phone: 843-699-0675
  • Fax: 843-758-0933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS C ROUSE
Title or Position: OWNER / MEMBER
Credential:
Phone: 843-758-0675