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General NPI Number Information
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NPI Number | 1972610301
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Entity Type | Organization
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Legal Business Name | FETTER HEALTH CARE NETWORK, INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 51 NASSAU ST
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City | CHARLESTON
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State | SC
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Zip | 29403-5513
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Country | US
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Telephone | 843-722-4112
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Fax | 843-577-8960
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Provider Business Mailing Address
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Address Line | 51 NASSAU ST
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City | CHARLESTON
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State | SC
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Zip | 29403-5513
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Country | US
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Telephone | 843-722-4112
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Fax | 843-577-8960
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. REUBEN J PETTIFORD
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Credential |
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Telephone | 843-722-4112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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