MEDICARE: WACCAMAW COMMUNITY CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1275861536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WACCAMAW COMMUNITY CARE, LLC

Provider Business Mailing Address
First Line	:	4301 DICK POND RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6807
Country	:	US
Telephone Number	:	843-652-8100
Fax Number	:	843-652-8122

Provider Business Practice Location Address
First Line	:	4301 DICK POND RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-6807
Country	:	US
Telephone Number	:	843-652-8100
Fax Number	:	843-652-8122

Authorized Official
Title or Position	:	DIRECTOR;GEORGETOWN PHYSICIAN SERVI
Name	:	MRS. BROOKE COX GASKINS
Credential	:
Telephone Number	:	843-520-8441

Provider Enumeration Date	:	11/25/2009
Last Update Date	:	11/18/2010

Similar Medicare Providers

1598742041 — ADVANTAGE HEALTH CENTER, LLC
Practice Location Address:

4301 HIGHWAY 544
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-215-5000
Practice Fax: 843-215-5005

1467698621 — MRS. SHELLEY M GILBERT RPA-C
Practice Location Address:

4301 DICK POND RD
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-652-8100
Practice Fax: 843-652-8122

1285931725 — CHRISTOPHER G GARAVITO MPT
Practice Location Address:

4125 DICK POND RD
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-999-0284
Practice Fax:

1659717452 — MRS. MEGAN ELVIS HASELDEN PA-C
Practice Location Address:

4301 DICK POND RD
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-652-8100
Practice Fax: 843-652-8122

1245670934 — ALEXIS JO BROWN MD
Practice Location Address:

4301 DICK POND RD
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-652-8100
Practice Fax: 843-652-8122

1043630387 — JACOB HURLAN BRAZEE MD
Practice Location Address:

4301 DICK POND RD
MYRTLE BEACH, SC
29588-6807

Practice Phone: 843-652-8100
Practice Fax: 843-652-8122

Directions to “WACCAMAW COMMUNITY CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.