Organization
KSF LLC
Active
Other names
The Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH D SHEALY M.D. (PRESIDENT)
(803) 825-7948
Entity
Organization
Contact information
Practice address
1025 W MEETING ST, SUITE 200, LANCASTER, SC 29720-2204
(803) 285-7948
(803) 283-4329
Mailing address
1025 W MEETING ST, SUITE 200, LANCASTER, SC 29720-2204
(803) 285-7948
(803) 283-4329
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0716208
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6028500001
MEDICARE DME (PTAN)
SC
05
—
DE3106
—
SC
Enumeration date
10/22/2007
Last updated
10/10/2023
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