| Coastal Urgent Care & Family Medicine | |
|
201 Business Center Dr Ste A Pawleys Island SC 29585-6522 | |
| (888) 467-1117 | |
| (888) 485-3336 |
| Full Name | Coastal Urgent Care & Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 Business Center Dr Ste A, Pawleys Island, South Carolina |
| Authorized Official Name and Position | Gerald Francis Congdon (MANAGING PHYSICIAN) |
| Authorized Official Contact | 8884671117 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Urgent Care & Family Medicine 201 Business Center Dr Ste A Pawleys Island SC 29585-6522 Ph: (888) 467-1117 | Coastal Urgent Care & Family Medicine 201 Business Center Dr Ste A Pawleys Island SC 29585-6522 Ph: (888) 467-1117 |
| NPI Number | 1467628867 |
|---|---|
| Provider Enumeration Date | 05/06/2008 |
| Last Update Date | 10/28/2015 |
| Medicare PECOS PAC ID | 7719278480 |
|---|---|
| Medicare Enrollment ID | O20160628000963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467628867 | NPI | - | NPPES |
| GP6613 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Marie L Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508840364 PECOS PAC ID: 5496644684 Enrollment ID: I20040315000600 |
| Provider Name | Gerald F Congdon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568446326 PECOS PAC ID: 0345329835 Enrollment ID: I20080508000785 |
| Provider Name | Rebecca Ann Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053638973 PECOS PAC ID: 2860523628 Enrollment ID: I20110907001594 |
| Provider Name | Regina R Evans |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134113871 PECOS PAC ID: 8224091954 Enrollment ID: I20160629000636 |
| Provider Name | Danielle Olivia Woodley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154860369 PECOS PAC ID: 7315276664 Enrollment ID: I20190911002023 |
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