MEDICARE: MYCHIROMED, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	2874	SC
2	111N00000X	Chiropractor	2874	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12137533	OTHER	SC	MULTIPLAN
2	2164911	OTHER	SC	FIRST HEALTH
3	2164911	OTHER	SC	CCN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063465045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MYCHIROMED, P.A.

Provider Business Mailing Address
First Line	:	4012 POSTAL WAY STE A
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-3298
Country	:	US
Telephone Number	:	843-236-4400
Fax Number	:	843-481-1976

Provider Business Practice Location Address
First Line	:	4012 POSTAL WAY STE A
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-3298
Country	:	US
Telephone Number	:	843-236-6291
Fax Number	:	843-872-9190

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NEAL WARREN LANGE JR.
Credential	:	DC
Telephone Number	:	843-236-4400

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	02/23/2026

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Directions to “MYCHIROMED, P.A. ” Practice Location

Language	Start Address	Practice Location

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