Healthcare Provider Details

I. General information

NPI: 1598380412
Provider Name (Legal Business Name): FELICIA D RUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 HIDDEN OAKS DR
WEDGEFIELD SC
29168-9523
US

IV. Provider business mailing address

1455 HIDDEN OAKS DR
WEDGEFIELD SC
29168-9523
US

V. Phone/Fax

Practice location:
  • Phone: 803-468-5364
  • Fax:
Mailing address:
  • Phone: 803-468-5364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number7299
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number7299
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number7299
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number7299
License Number StateSC
# 5
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number7299
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number7299
License Number StateSC
# 7
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number7299
License Number StateSC
# 8
Primary TaxonomyN
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number7299
License Number StateSC
# 9
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number7299
License Number StateSD
# 10
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number7299
License Number StateSC
# 11
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number7299
License Number StateSC
# 12
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number7299
License Number StateSC
# 13
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number7299
License Number StateSC
# 14
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number7299
License Number StateSC
# 15
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number7299
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: