Healthcare Provider Details

I. General information

NPI: 1922912070
Provider Name (Legal Business Name): FOOTHILLS COMMUNITY HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 ANTREVILLE HWY
IVA SC
29655-9548
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 864-512-4088
  • Fax:
Mailing address:
  • Phone: 864-224-0822
  • Fax: 864-306-7722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL

VIII. Authorized Official

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