MEDICARE: SOUTH STRAND URGENT CARE LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1639422934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH STRAND URGENT CARE LLC

Provider Business Mailing Address
First Line	:	1945 GLENNS BAY RD STE B
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29575-4833
Country	:	US
Telephone Number	:	843-650-4006
Fax Number	:	843-650-4225

Provider Business Practice Location Address
First Line	:	11405 OCEAN HWY
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585-8339
Country	:	US
Telephone Number	:	843-979-4006
Fax Number	:	843-650-4019

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	DEANA W FINLEY
Credential	:
Telephone Number	:	843-650-4006

Provider Enumeration Date	:	10/24/2012
Last Update Date	:	12/03/2018

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Directions to “SOUTH STRAND URGENT CARE LLC ” Practice Location

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