| Fetter Health Care Network-elijahwright Site | |
|
1681 Old Highway 6 Cross SC 29436-3602 | |
| (843) 753-2334 | |
| (843) 753-7986 |
| Full Name | Fetter Health Care Network-elijahwright Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 1681 Old Highway 6, Cross, South Carolina |
| Authorized Official Name and Position | Aretha Jones (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8437224112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fetter Health Care Network-elijahwright Site 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | Fetter Health Care Network-elijahwright Site 1681 Old Highway 6 Cross SC 29436-3602 Ph: (843) 753-2334 |
| NPI Number | 1396859823 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 10/18/2016 |
| Medicare PECOS PAC ID | 9032215199 |
|---|---|
| Medicare Enrollment ID | O20110302000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396859823 | NPI | - | NPPES |
| 421839 | Other | WI | MEDICARE PART A# |
| FQC027 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |