Healthcare Provider Details

I. General information

NPI: 1700717410
Provider Name (Legal Business Name): GRAND STRAND REGIONAL MEDICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 VILLAGE CENTER BLVD STE 110
MYRTLE BEACH SC
29579-3589
US

IV. Provider business mailing address

199 VILLAGE CENTER BLVD STE 110
MYRTLE BEACH SC
29579-3589
US

V. Phone/Fax

Practice location:
  • Phone: 615-344-9551
  • Fax:
Mailing address:
  • Phone: 615-344-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARK EDWARD SIMS
Title or Position: CEO
Credential:
Phone: 843-692-1104