Healthcare Provider Details

I. General information

NPI: 1861057333
Provider Name (Legal Business Name): ORTHOSC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 VILLAGE CENTER BLVD STE 100
MYRTLE BEACH SC
29579-6706
US

IV. Provider business mailing address

210 VILLAGE CENTER BLVD STE 200
MYRTLE BEACH SC
29579-6706
US

V. Phone/Fax

Practice location:
  • Phone: 843-491-4937
  • Fax: 843-353-3461
Mailing address:
  • Phone: 843-353-3460
  • Fax: 843-353-3461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JENIFER EDELEN
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 843-213-6149