Organization
FETTER HEALTH CARE NETWORK, INC
Active
Other names
Franklin C Fetter Family Health Center-Hospitalization
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REUBEN J PETTIFORD (EXECUTIVE DIRECTOR)
(843) 722-4112
Entity
Organization
Contact information
Practice address
51 NASSAU ST, CHARLESTON, SC 29403-5513
(843) 722-4112
(843) 577-8960
Mailing address
51 NASSAU ST, CHARLESTON, SC 29403-5513
(843) 722-4112
(843) 577-8960
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBP015
—
SC
Enumeration date
11/09/2006
Last updated
04/15/2015
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