# EAST COAST RETINA, PA

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

## Provider details

- **NPI number:** 1730138157
- **Authorized official:** DR. STEPHEN J PHILLIPS M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (843) 215-3363

## Contact information

- **Practice address:** 8609 MONTAGUE LN, MYRTLE BEACH, SC 29588-4504
- **Practice address phone:** (843) 215-3363
- **Practice address fax:** (843) 215-7201
- **Mailing address:** 8609 MONTAGUE LN, MYRTLE BEACH, SC 29588-4504
- **Mailing address phone:** (843) 215-3363
- **Mailing address fax:** (843) 215-7201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 26821 | SC | Yes |

## Other

- **Enumeration date:** 05/10/2006
- **Last updated:** 09/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4339 | — | SC |