# GRAND STRAND MOBILE WOUND CARE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508670837
- **Authorized official:** MR. JEFFREY HATHWAY PA-C (OWNER)
- **Authorized official phone:** (617) 959-4427

## Contact information

- **Practice address:** 1297 PROFESSIONAL DR STE 201, MYRTLE BEACH, SC 29577-5713
- **Practice address phone:** (803) 999-6863
- **Practice address fax:** (855) 834-3003
- **Mailing address:** 580 STARLIT WAY, MYRTLE BEACH, SC 29579-4322
- **Mailing address phone:** (803) 999-6863
- **Mailing address fax:** (855) 834-3003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/06/2025
- **Last updated:** 02/06/2025