Healthcare Provider Details

I. General information

NPI: 1912937624
Provider Name (Legal Business Name): HILTON HEAD HEALTH SYSTEM, L.P.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2738
US

IV. Provider business mailing address

PO BOX 741204
ATLANTA GA
30374-1204
US

V. Phone/Fax

Practice location:
  • Phone: 843-681-6122
  • Fax:
Mailing address:
  • Phone: 678-242-2002
  • Fax: 843-689-3670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number646
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: RON GROTELUSCHEN
Title or Position: CFO
Credential:
Phone: 843-689-8101