GRAND STRAND PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA (NPI# 1619157294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619157294 |
| Entity Type | Organization |
| Organization Name | GRAND STRAND PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA |
| Practice Address |
4610 Oleander Dr Suite 101 Myrtle Beach SC 29577-5752 |
| Practice Telephone | 8434972227 |
| Practice Fax Number | 8434499265 |
| Mailing Telephone | 8434972227 |
| Mailing Fax Number | 8434499265 |
| Enumeration Date | 2007-11-12 |
| Last Update Date | 2013-09-30 |
| Authorized Official Name | MS. LISA J PIERCE (BUSINESS MANAGER) |
| Authorized Official Telephone | 8434972227 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 15346 | SC | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 153461 | 05 |
| Street Address |
4610 OLEANDER DR SUITE 101 |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29577-5752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447393178 | Daryl Huffman | Dentist | 4610 Oleander Dr, Suite102, Myrtle Beach, SC 29577-5752 | 2007-02-14 |
| 1417598186 | Caitlin Mccormick | Nurse Practitioner | 4610 Oleander Dr, Myrtle Beach, SC 29577-5752 | 2019-10-03 |
| 1841500972 | Robert S. Merritt Dmd PC | Dentist | 4610 Oleander Dr, Suite 103, Myrtle Beach, SC 29577-5752 | 2010-10-07 |
| 1740478668 | Oleander Family and Cosmetic Dentistry, LLC | Dentist | 4610 Oleander Dr, Suite 103, Myrtle Beach, SC 29577-5752 | 2007-10-04 |
| 1245428283 | Robert Spann Merritt | Dentist | 4610 Oleander Dr, Suite103, Myrtle Beach, SC 29577-5752 | 2007-10-03 |
| 1679616726 | Edward V. Horton | Dentist | 4610 Oleander Dr, Suite 103, Myrtle Beach, SC 29577-5752 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124536446 | Well Care Home Health of The Lowcountry | Home Health | 1039 44th Ave N Ste 101, Myrtle Beach, SC 29577 | 2018-01-22 |
| 1518470913 | Guillot Enterprises, LLC | Hearing Instrument Specialist | 1294 Professional Dr., Suite C, Myrtle, SC 29577 | 2017-11-08 |
| 1598288227 | Ryan Shepherd | Pharmacist | 1705 South Kings Highway, Myrtle Beach, SC 29577 | 2017-07-25 |
| 1184176554 | Shannon Long | Counselor | 1293 Professional Drive, Suite D Office 222, Myrtle Beach, SC 29577 | 2016-11-01 |
| 1265898191 | Coastal Carolina Infectious Disease, LLC | Internal Medicine | 1110 London St Ste 102, Myrtle Beach, SC 29577 | 2016-01-07 |
| 1548639933 | Susan Lang | Social Worker | 1273 Professional Dr., Suite A #104, Myrtle Beach, SC 29577 | 2015-09-16 |
| 1043600893 | Kenneth Edward Smith | Counselor | 1125 48th Avenue North, Myrtle Beach, SC 29577 | 2015-02-02 |
| 1902203615 | Sc Nursing Services LLC | Home Infusion | 1297 Professional Drive, Suite 201 C3, Myrtle Beach, SC 29577 | 2014-11-24 |
| 1881007946 | Intercoastal Endo, PC | Dentist | 4382 Oleander Dr, Myrtle Beach, SC 29577 | 2014-06-06 |
| 1891115739 | Julie Hite | Pharmacist | 540 Seaboard Street, Myrtle Beach, SC 29577 | 2014-04-18 |
| Find all providers in zip 29577 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578803672 | Felicia Squires | Specialist | 3941 Saint Ives Rd Unit 911, Myrtle Beach, SC 29588-1174 | 2013-02-26 |
| 1457603938 | David Scott Lawrence | Specialist | 514 Alder St, Suite 6, Myrtle Beach, SC 29577-3854 | 2012-10-09 |
| 1467731406 | Gamal S Boutros Md | Specialist | 605 Briarwood Dr, Suite E, Myrtle Beach, SC 29572-6734 | 2011-08-09 |
| 1205014990 | Patricia Ann Esposito | Specialist | 7719 N Kings Hwy, Myrtle Beach, SC 29572-3042 | 2008-02-05 |
| 1881884708 | Lindsey Pritchard Chappell | Specialist | 121 Gateway Rd., Suite B, Myrtle Beach, SC 29526 | 2007-07-26 |
| 1619904752 | Deborah Cook | Specialist | 3675 Spruce Dr, Myrtle Beach, SC 29577-5005 | 2006-06-26 |
| 1649245358 | John M Davis | Specialist | 849 82nd Pkwy, Myrtle Beach, SC 29572-4614 | 2006-02-17 |
| 1952385288 | Coastal Cardiovascular Surgery, LLC | Specialist | 933 Medical Cir, Myrtle Beach, SC 29572-4116 | 2005-11-30 |
| 1740276971 | Amy L King | Specialist | 4378 Oleander Dr, Myrtle Beach, SC 29577 | 2005-09-22 |
| 1760478242 | Russell Frank Stahl | Specialist | 920 Doug White Dr Ste 510, Myrtle Beach, SC 29572-4120 | 2005-09-21 |
| Find all providers in MYRTLE BEACH | ||||
| City | MYRTLE BEACH |
| Zip Code | 29577 |
Please comment or provide details below to improve the information on GRAND STRAND PLASTIC & RECONSTRUCTIVE SURGERY CENTER PA.
| 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.