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NPI Code Detail

MEDICARE: FETTER HEALTH CARE NETWORK, INC

MEDICARE: FETTER HEALTH CARE NETWORK, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972610301
Entity Type Code : Organization
Provider Name (Legal Business Name) : FETTER HEALTH CARE NETWORK, INC
Provider Business Mailing Address
First Line : 51 NASSAU ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29403-5513
Country : US
Telephone Number : 843-722-4112
Fax Number : 843-577-8960
Provider Business Practice Location Address
First Line : 51 NASSAU ST
Second Line :
City : CHARLESTON
State : SC
Zip : 29403-5513
Country : US
Telephone Number : 843-722-4112
Fax Number : 843-577-8960
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. REUBEN J PETTIFORD
Credential :
Telephone Number : 843-722-4112
Provider Enumeration Date : 08/23/2006
Last Update Date : 04/15/2015

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Directions to “FETTER HEALTH CARE NETWORK, INC ” Practice Location

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