Organization
COASTAL CAROLINA MEDICAL CENTER INC
Active
Other names
Coastal Carolina Medical Center-ED Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
RON GROTELUSCHEN (CFO)
(843) 784-8076
Entity
Organization
Contact information
Practice address
1000 MEDICAL DRIVE, HARDEEVILLE, SC 29927
(843) 784-8000
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4342
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4209
—
SC
Enumeration date
08/21/2008
Last updated
03/22/2022
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