| Coastal Carolina Primary Care, Llc | |
|
106 W Main St Moncks Corner SC 29461-2601 | |
| (843) 761-1995 | |
| Not Available |
| Full Name | Coastal Carolina Primary Care, Llc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 106 W Main St, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Wayne O Whinney (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8438567924 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Carolina Primary Care, Llc 106 W Main St Moncks Corner SC 29461-2601 Ph: (843) 761-1995 | Coastal Carolina Primary Care, Llc 106 W Main St Moncks Corner SC 29461-2601 Ph: (843) 761-1995 |
| NPI Number | 1164783643 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 05/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164783643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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