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Organization

COASTAL CAROLINA MEDICAL CENTER, INC.

Active
Parent organization
COASTAL CAROLINA HOSPITAL
Other names
Coastal Carolina Medical Associates
Organization subpart
Yes

Provider details

NPI number
Legal business name
COASTAL CAROLINA HOSPITAL
Authorized official
MR. RON O. GROTELUSCHEN (CFO)
(843) 784-8076
Entity
Organization

Contact information

Practice address
1010 MEDICAL CENTER DR, SUITE 240, HARDEEVILLE, SC 29927-3447
(843) 784-8293
(843) 784-7801
Mailing address
PO BOX 741261, ATLANTA, GA 30374-1261
(843) 784-8293
(843) 784-7801

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
RHC 551
SC
Enumeration date
02/02/2011
Last updated
03/22/2022
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