# FETTER HEALTH CARE NETWORK, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Franklin C Fetter Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932213378
- **Authorized official:** MR. REUBEN J PETTIFORD (CEO)
- **Authorized official phone:** (843) 722-4112

## Contact information

- **Practice address:** 110 EXECUTIVE PKWY, MONCKS CORNER, SC 29461-3930
- **Practice address phone:** (843) 761-7744
- **Mailing address:** 51 NASSAU STREET, CHARLESTON, SC 29403-5513
- **Mailing address phone:** (843) 722-4112
- **Mailing address fax:** (843) 577-8960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |

## Other

- **Enumeration date:** 08/19/2006
- **Last updated:** 04/15/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | FQC049 | — | SC |