Healthcare Provider Details

I. General information

NPI: 1982470910
Provider Name (Legal Business Name): INVOCARES FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 MEDICAL CIR STE E
WEST COLUMBIA SC
29169-3639
US

IV. Provider business mailing address

160 MEDICAL CIR STE E
WEST COLUMBIA SC
29169-3639
US

V. Phone/Fax

Practice location:
  • Phone: 803-764-2406
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANTOINETTE LASHONDA BELTON
Title or Position: PRESIDENT
Credential:
Phone: 912-682-3430