| 360 Health Care | |
|
4810 N Kings Hwy Myrtle Beach SC 29577-2558 | |
| (843) 692-9243 | |
| Not Available |
| Full Name | 360 Health Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 4810 N Kings Hwy, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Jin Li Dong (OWNER) |
| Authorized Official Contact | 8436929243 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| 360 Health Care 4810 N Kings Hwy Myrtle Beach SC 29577-2558 Ph: (843) 692-9243 | 360 Health Care 4810 N Kings Hwy Myrtle Beach SC 29577-2558 Ph: (843) 692-9243 |
| NPI Number | 1962881268 |
|---|---|
| Provider Enumeration Date | 05/20/2015 |
| Last Update Date | 05/20/2015 |
| Medicare PECOS PAC ID | 4183930795 |
|---|---|
| Medicare Enrollment ID | O20150827001289 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962881268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 27 (South Carolina) | Secondary |
| 261QM2500X | Clinic/center - Medical Specialty | MD18446 (South Carolina) | Primary |
| Provider Name | Jin Li Dong |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1518912286 PECOS PAC ID: 1254244189 Enrollment ID: I20040521001027 |
| Provider Name | Robert Lewis Pugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407814791 PECOS PAC ID: 7719025964 Enrollment ID: I20100925000030 |
| Provider Name | Jeannine Rummel |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1437443058 PECOS PAC ID: 4385899608 Enrollment ID: I20130312000332 |
| Provider Name | Jidong Sun |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033158282 PECOS PAC ID: 1456248509 Enrollment ID: I20200409003684 |
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