Organization
GRAND STRAND SENIOR HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PATRICK BIRMINGHAM (DIRECTOR)
(615) 373-7625
Entity
Organization
Contact information
Practice address
5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
(843) 839-6192
(843) 839-6164
Mailing address
5046 HIGHWAY 17 BYP S, SUITE 100, MYRTLE BEACH, SC 29588-4503
(843) 839-6192
(843) 839-6164
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3814
—
SC
Enumeration date
10/18/2005
Last updated
01/23/2008
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