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Organization
COASTAL CANCER CENTER LLC
Active
Organization
COASTAL CANCER CENTER LLC
Active
Other names
COASTAL CANCER CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY PAUDEL MD (PRESIDENT)
(843) 692-5000
Entity
Organization
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
2085R0001X
Radiation Oncology Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7902484
—
NC
05
—
PA8189
—
SC
05
—
PG1907
—
SC
05
—
PG1908
—
SC
Enumeration date
07/20/2006
Last updated
09/08/2025
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