person
Roosevelt Stackhouse JR., RN
Home Health Registered Nurse in Florence, South Carolina
NPI 1225455074

Roosevelt Stackhouse JR. is a Home Health Registered Nurse based in Mullins, SC and is specialized in Home Health. Roosevelt Stackhouse JR. practices in Florence, SC and has the professional credentials of RN. The NPI Number for Roosevelt Stackhouse JR. is 1225455074 and holds a License No. 37318 (South Carolina).

The current practice location address for Roosevelt Stackhouse JR. is 1705 W Evans St, Florence, SC and can be reached out via phone at 843-774-1577 and via fax at 843-774-1047. You can also correspond with Roosevelt Stackhouse JR. through the mailing address at PO BOX 648, MULLINS, SC - 29574-0648 (mailing address contact number: 843-464-0767).

Location: 1705 W Evans St, Florence, SC, 29574-0648
person
Provider Profile Details
NPI Number
1225455074
Provider Name
Roosevelt Stackhouse JR.
Credential
RN
Provider Entity Type
Individual
Gender
Male
Address
1705 W Evans St, Florence, SC, 29574-0648
Phone Number
843-774-1577
Fax Number
843-774-1047
Provider Enumeration Date
03/18/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1705 W Evans St
City
State
Zip
29501-3331
Phone Number
843-774-1577
Fax Number
843-774-1047
person
Provider Business Mailing Address Details
Address
1705 W Evans St
City
State
Zip
29501-3331
Phone Number
843-774-1577
Fax Number
843-774-1047
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Home Health
Taxonomy
License No.
37318 (South Carolina)
Definition
Definition to come...
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