COASTAL CAROLINA MEDICAL CENTER, INC


Address: 10911 N Jacob Smart Blvd, D, Ridgeland, SC 29936-2729
Phone: 8437843101

COASTAL CAROLINA MEDICAL CENTER, INC (NPI# 1124307509) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124307509
Entity Type Organization
Organization Name COASTAL CAROLINA MEDICAL CENTER, INC
Other Organization Name COASTAL MEDICAL ASSOCIATES
Practice Address 10911 N Jacob Smart Blvd
D
Ridgeland
SC 29936-2729
Mailing Address Po Box 741261
Atlanta
GA 30374-1261
Practice Telephone 8437843101
Practice Fax Number 8437845313
Mailing Telephone 8437843101
Mailing Fax Number 8437845313
Enumeration Date 2011-08-16
Last Update Date 2016-05-26
Authorized Official Name WESLEY O. JAMES (REGIONAL CFO, TENET)
Authorized Official Telephone 4042655009
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR1300X Clinic/Center
Specialization: Rural Health
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Coastal Medical Associates Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1518007681 Coastal Carolina Medical Center, Inc Clinic/Center 10911 North Jacob Smart Blvd, #d, Ridgeland, SC 29936-2729 2007-02-07

Office Location

Street Address 10911 N JACOB SMART BLVD
D
City RIDGELAND
State SC
Zip Code 29936-2729

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1699316075 Ghc-hilton Head, LLC Hospice Care, Community Based 65 Schinger Avenue, Suite 103, Ridgeland, SC 29936 2019-10-07
1568884385 Kristen Reeves Occupational Therapist 10616 South Jacob Smart Boulevard, Ridgeland, SC 29936 2014-01-14
1942547138 Jennifer Loadholt Moore Social Worker 204 North Railroad Avenue, Ridgeland, SC 29936 2013-01-09
1568719649 Jennifer Lynn Coleman Counselor 203 N. Railroad Ave., Ridgeland, SC 29936 2012-08-08
1184945925 Niles Edemeka Carter Obstetrics & Gynecology 1320 S. Ribaut Rd, Port Royal, SC 29936 2010-06-16
1831328459 Jamie Singleton Pediatrics 1320 S. Ribaut Rd., Beaufort, SC 29936 2009-07-02
1487801668 Laboratory Corporation of America Holdings Clinical Medical Laboratory 721 Okatie Hwy 170, Ridgeland, SC 29936 2008-08-19
1295912004 Ridgeland Dialysis LLC Clinic/Center 112 Weathersbee St, Ridgeland, SC 29936 2008-01-23
1518143221 Ridgeland Eye Associates LLC Ophthalmology 10668 South Jacob Smart Boulevard, Ridgeland, SC 29936 2008-01-11
1053594713 Caring Hands Health Equipment & Supplies, Inc. Durable Medical Equipment & Medical Supplies 107d East Main Street, Ridgeland, SC 29936 2007-12-17
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Taxonomy Information

Taxonomy Code 261QR1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rural Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518007681 Coastal Carolina Medical Center, Inc Clinic/Center 10911 North Jacob Smart Blvd, #d, Ridgeland, SC 29936-2729 2007-02-07
1356444764 Margaret F Curtis Clinic/Center 90 W Wilson Street, Ridgeland, SC 29936-8724 2006-09-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1508482050 The Palmetto Clinics, LLC Clinic/Center 463 Calhoun Ave Ste A-2, Greenwood, SC 29649-2063 2020-06-21
1962969154 The Palmetto Palace Clinic/Center 217 Flat St E, Allendale, SC 29810-4647 2019-02-25
1972014652 Mcleod Physician Associates II Clinic/Center 1040 Marlboro Way Ste 1, Bennettsville, SC 29512-2494 2017-10-20
1508377284 Mcleod Physician Associates II Clinic/Center 1076 Marlboro Way Ste 3, Bennettsville, SC 29512-2495 2017-10-20
1154786960 R Dale Padgett Md Pa Clinic/Center 1727 Villagepark Dr, Orangeburg, SC 29118 2015-12-21
1043602428 Greenville Health System Clinic/Center 208 Frontage Rd Ste 1, Clemson, SC 29631-1671 2015-02-23
1114204153 Mcleod Physician Associates II Clinic/Center 5260 Highway 9, Green Sea, SC 29545-4930 2011-11-04
1700160157 Mackey Family Practice, Pa Clinic/Center 8351 Charlotte Hwy, Suite 200, Indian Land, SC 29707-6552 2011-10-04
1588943021 Edisto Regional Health Services Inc. Clinic/Center 185 Mcgee St, Bamberg, SC 29003-1154 2011-08-16
1154621829 Marion Physician Services LLC Clinic/Center 108a E Main St, Latta, SC 29565-1617 2010-10-28
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Competitor

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City RIDGELAND
Zip Code 29936

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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