Healthcare Provider Details

I. General information

NPI: 1811950884
Provider Name (Legal Business Name): SOUTH CAROLINA FOOT CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1754 WOODRUFF RD STE 308
GREENVILLE SC
29607-5933
US

IV. Provider business mailing address

1754 WOODRUFF RD STE 308
GREENVILLE SC
29607-5933
US

V. Phone/Fax

Practice location:
  • Phone: 864-640-4595
  • Fax: 864-640-4553
Mailing address:
  • Phone: 864-640-4595
  • Fax: 864-640-4553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number48
License Number StateSC

VIII. Authorized Official

Name: DR. WILLIAM JAY MCANINCH
Title or Position: VICE-PRESIDENT
Credential: DPM
Phone: 864-640-4595