| Fetter Health Care Network-hollywood Site | |
|
5225 Highway 165 Hollywood SC 29449-6144 | |
| (843) 889-2272 | |
| (843) 889-2274 |
| Full Name | Fetter Health Care Network-hollywood Site |
|---|---|
| Speciality | Clinic/Center |
| Location | 5225 Highway 165, Hollywood, 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-hollywood Site 51 Nassau Street Charleston SC 29403-5513 Ph: (843) 722-4112 | Fetter Health Care Network-hollywood Site 5225 Highway 165 Hollywood SC 29449-6144 Ph: (843) 889-2272 |
| NPI Number | 1386792976 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 10/18/2016 |
| Medicare PECOS PAC ID | 9032215199 |
|---|---|
| Medicare Enrollment ID | O20080819000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386792976 | NPI | - | NPPES |
| FQC047 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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