Fetter Health Care Network-walterboro Site | |
302 Medical Park Dr Suite 111 Walterboro SC 29488-5747 | |
(843) 549-6853 | |
(843) 549-7961 |
Full Name | Fetter Health Care Network-walterboro Site |
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Speciality | Clinic/Center |
Location | 302 Medical Park Dr, Walterboro, South Carolina |
Authorized Official Name and Position | Aretha R 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-walterboro Site 51 Nassau Street Charleston SC 29403-5513 Ph: (843) 722-4112 | Fetter Health Care Network-walterboro Site 302 Medical Park Dr Suite 111 Walterboro SC 29488-5747 Ph: (843) 549-6853 |
NPI Number | 1447308119 |
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Provider Enumeration Date | 01/08/2007 |
Last Update Date | 10/28/2022 |
Medicare PECOS PAC ID | 9032215199 |
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Medicare Enrollment ID | O20080819000368 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447308119 | 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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