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1120 2nd Ave S # B North Myrtle Beach SC 29582-3108 | |
| (864) 501-0751 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1120 2nd Ave S # B, North Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Jody Addair (CLINICAL OPS IMPLEMENTATION COORD.) |
| Authorized Official Contact | 3175560017 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 1120 2nd Ave S # B North Myrtle Beach SC 29582-3108 Ph: (864) 501-0751 |
| NPI Number | 1295563674 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 11/22/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295563674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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