Organization
COASTAL CAROLINA PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE O WHINNEY (AUTHORIZED OFFICIAL)
(843) 856-7924
Entity
Organization
Contact information
Practice address
106 W MAIN ST, MONCKS CORNER, SC 29461-2601
(843) 761-1995
Mailing address
106 W MAIN ST, MONCKS CORNER, SC 29461-2601
(843) 761-1995
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2012
Last updated
05/31/2012
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