ROOSEVELT STACKHOUSE JR. RN
NPI 1225455074
Registered Nurse - Home Health in Florence, SC

Active since March 18, 2014
1705 W EVANS ST, FLORENCE, SC 29501(843) 774-1577(843) 774-1047 Get Directions Write a Review

NPPES record last updated: March 18, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Roosevelt Stackhouse Jr. Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROOSEVELT STACKHOUSE JR. RN (NPI 1225455074) is an individual home health provider in Florence, South Carolina, licensed in South Carolina (37318) and active in the NPI registry since March 2014.

NPPES Registry Identity

NPI1225455074
Entity TypeIndividualMale
Primary Taxonomy163WH0200X
Provider Legal NameROOSEVELT STACKHOUSE JR.Credential: RN
Location Address1705 W EVANS STFlorence, SC 29501-3331
Mailing AddressPo Box 648, 521 Gilchrist RoadMullins, SC 29574-0648 · (843) 464-0767 · Fax (843) 464-0767
Fax(843) 774-1047
Sole ProprietorYes
Enumeration DateMarch 18, 2014
NPI 1225455074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRegistered Nurse · Home HealthNursing Service Providers
Taxonomy Code163WH0200X
License Licensed in SC · 37318
1705 W EVANS ST, Florence, SC 29501

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Registered Nurse (Community Health)
1705 W EVANS ST
FLORENCE, SC 29501
Home Health
1705 W EVANS ST
FLORENCE, SC 29501
Registered Nurse (Enterostomal Therapy)
1705 W EVANS ST
FLORENCE, SC 29501
Registered Nurse (Community Health)
1705 W EVANS ST
FLORENCE, SC 29501
Registered Nurse
1705 W EVANS ST
FLORENCE, SC 29501
Registered Nurse (Community Health)
1705 W EVANS ST
FLORENCE, SC 29501
Registered Nurse (Home Health)
1705 W EVANS ST, DHEC HOME HEALTH
FLORENCE, SC 29501
Registered Nurse (Home Health)
1705 W EVANS ST
FLORENCE, SC 29501

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roosevelt Stackhouse's NPI number?

The NPI number for Roosevelt Stackhouse is 1225455074. It was assigned to this individual provider in the NPPES registry on March 18, 2014.

Where is Roosevelt Stackhouse located?

Roosevelt Stackhouse practices at 1705 W Evans St, Florence, SC 29501. The listed phone number is (843) 774-1577.

What is Roosevelt Stackhouse's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Home Health, with taxonomy code 163WH0200X.

When was this NPI record last updated?

The NPPES record for Roosevelt Stackhouse was last updated on March 18, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.