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General NPI Number Information
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NPI Number | 1447756762
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Entity Type | Organization
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Legal Business Name | COASTAL CANCER CENTER LLC
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 8121 ROURK ST
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4128
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Country | US
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Telephone | 843-692-5000
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Fax | 843-429-5055
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Provider Business Mailing Address
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Address Line | 8121 ROURK ST
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City | MYRTLE BEACH
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State | SC
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Zip | 29572-4128
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Country | US
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Telephone | 843-692-5000
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Fax | 843-429-5055
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Authorized Official
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Title or Position | PHARMACIST
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Name | ERICK GRIER
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Credential |
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Telephone | 843-933-7513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 17849
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License Number State | SC
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