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General NPI Number Information
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NPI Number | 1295284784
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Entity Type | Organization
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Legal Business Name | CAROLINA FOREST URGENT CARE LLC
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 185 FRESH DR SUITE A
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-4436
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Country | US
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Telephone | 843-945-3030
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Fax | 843-492-4479
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Provider Business Mailing Address
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Address Line | PO BOX 2128
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-2128
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Country | US
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Telephone | 854-223-4831
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Fax | 854-212-7381
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH V VANDERGRIFF
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Credential | MD
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Telephone | 843-945-3030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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