# GRAND STRAND SENIOR HEALTH CENTER, LLC

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

## Provider details

- **NPI number:** 1649269085
- **Authorized official:** MR. PATRICK BIRMINGHAM (DIRECTOR)
- **Authorized official phone:** (615) 373-7625

## Contact information

- **Practice address:** 5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
- **Practice address phone:** (843) 839-6192
- **Practice address fax:** (843) 839-6164
- **Mailing address:** 5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
- **Mailing address phone:** (843) 839-6192
- **Mailing address fax:** (843) 839-6164

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2005
- **Last updated:** 01/23/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP3814 | — | SC |