Coastal Carolina Primary Care, Llc

NPI 1164783643 - Clinic/Center - 261QR1300X

NPI Details
NPI 1164783643
Enumeration Date 05/31/2012
Last Updated 05/31/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name WAYNE O WAYNE
Position AUTHORIZED OFFICIAL
Phone (843) 761-1995
Fax
Practice Location
106 W MAIN ST
MONCKS CORNER SC, 29461-2601, US
Phone (843) 761-1995
Fax
Business Location
106 W MAIN ST
MONCKS CORNER SC, 29461-2601, US
Phone (843) 761-1995
Fax
Toxanomy
Taxonomy Code 261QR1300X
License State
License Number
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According to our database, Coastal Carolina Primary Care, Llc NPI is 1164783643, taxonomy code is 261QR1300X Coastal Carolina Primary Care, Llc physically located at 106 W Main St, Moncks Corner SC, 29461-2601. NPI Number 1033115704 has the healthcare provider type.

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1164783643 NPI number is provided on an as is basis without warranty of any kind. 1164783643 is maintained by the National Plan & Provider Enumeration System. The contents of Coastal Carolina Primary Care, Llc are for informational purposes only.