Mr Blaine B Rourke, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Myrtle Beach, South Carolina. His current practice location is
809 82nd Pkwy, Myrtle Beach, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(843) 692-1752.
Mr Blaine B Rourke is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184640740.
Provider's Profile
| Full Name | Mr Blaine B Rourke |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 809 82nd Pkwy, Myrtle Beach, South Carolina |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1184640740
- Provider Enumeration Date: 07/15/2006
- Last Update Date: 03/28/2021
Medicare PECOS Information:
- PECOS PAC ID: 8820078058
- Enrollment ID: I20131122001139
Medical Identifiers
Medical identifiers for Mr Blaine B Rourke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184640740 | NPI | - | NPPES |
| 8L5723 | Other | TX | MEDICARE PTAN |
| 182196901 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | PA03254 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blaine B Rourke is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Blaine B Rourke, DO
809 82nd Pkwy,
Myrtle Beach, SC 29572-4607
Ph: (843) 692-1752 | Mr Blaine B Rourke, DO
809 82nd Pkwy,
Myrtle Beach, SC 29572-4607
Ph: (843) 692-1752 |
Reviews and Comments