FETTER HEALTH CARE NETWORK INC NPI 1396859823

NPI Information

NPI: 1396859823
Provider Name: FETTER HEALTH CARE NETWORK INC

Doing Business As: FETTER HEALTH CARE NETWORK-ELIJAHWRIGHT SITE

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1681 OLD HIGHWAY 6
CROSS, SC
ZIP 29436
Phone: (843) 753-2334
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FETTER HEALTH CARE NETWORK INC is a federally qualified health center (fqhc) clinic center in Cross, SC. FETTER HEALTH CARE NETWORK INC NPI is 1396859823. The provider is registered as an organization entity type.
The provider Is Doing Business As Fetter Health Care Network-elijahwright Site.

The provider's business location address is:

1681 OLD HIGHWAY 6
CROSS, SC
ZIP 29436-602
Phone: (843) 753-2334
Fax: (843) 753-7986

The provider's authorized official is Aretha Jones .
The authorized official title is Executive Director and has the following contact phone number (843) 722-4112.

The CLIA number assigned to this NPI record is 42D0889954 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/19/2006 and was last updated on 10/18/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	FQC027	MEDICAID	SOUTH CAROLINA
2	421839	OTHER	WISCONSIN	MEDICARE PART A#

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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