Healthcare Provider Details

I. General information

NPI: 1639422934
Provider Name (Legal Business Name): SOUTH STRAND URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 12/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11405 OCEAN HWY
PAWLEYS ISLAND SC
29585-8339
US

IV. Provider business mailing address

1945 GLENNS BAY RD STE B
SURFSIDE BEACH SC
29575-4833
US

V. Phone/Fax

Practice location:
  • Phone: 843-979-4006
  • Fax: 843-650-4019
Mailing address:
  • Phone: 843-650-4006
  • Fax: 843-650-4225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DEANA W FINLEY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 843-650-4006