Provider Demographics
| NPI: | 1457007841 |
|---|---|
| Name: | FETTER HEALTH CARE NETWORK, INC. |
| Entity type: | Organization |
| Organization Name: | FETTER HEALTH CARE NETWORK, INC. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ARETHA |
| Authorized Official - Middle Name: | R |
| Authorized Official - Last Name: | JONES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 843-722-4112 |
| Mailing Address - Street 1: | 51 NASSAU ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | CHARLESTON |
| Mailing Address - State: | SC |
| Mailing Address - Zip Code: | 29403-5513 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 843-722-4112 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 679 ORANGEBURG RD UNIT F |
| Practice Address - Street 2: | |
| Practice Address - City: | SUMMERVILLE |
| Practice Address - State: | SC |
| Practice Address - Zip Code: | 29483-9038 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 843-722-4112 |
| Practice Address - Fax: | 843-577-9550 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | Yes |
| Parent Organization LBN: | FETTER HEALTH CARE NETWORK, INC. |
| Parent Organization TIN: | <UNAVAIL> |
| Enumeration Date: | 2022-02-24 |
| Last Update Date: | 2025-11-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |