Organization
RAPHA FAMILY FOOTCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEULAH M. BROOKS DPM (PODIATRIST)
(843) 722-8628
Entity
Organization
Contact information
Practice address
172 SPRING ST, CHARLESTON, SC 29403-5220
(843) 722-8628
(843) 722-1055
Mailing address
PO BOX 1633, WALTERBORO, SC 29488-0016
(843) 722-8628
(843) 722-1055
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00123
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE2865
MEDICAID DME
SC
01
—
DF5446
MEDICARE RAIL ROAD
SC
05
—
GP9914
—
SC
Enumeration date
10/24/2006
Last updated
09/26/2008
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