Healthcare Provider Details

I. General information

NPI: 1750280863
Provider Name (Legal Business Name): GRAND STRAND REGIONAL MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 CHURCH ST
CONWAY SC
29526-2964
US

IV. Provider business mailing address

1720 CHURCH ST
CONWAY SC
29526-2964
US

V. Phone/Fax

Practice location:
  • Phone: 843-279-6305
  • Fax:
Mailing address:
  • Phone: 843-279-6305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0002X
TaxonomyEmergency Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK SIMS
Title or Position: CEO
Credential:
Phone: 843-692-1000