MEDICARE: GRAND STRAND REGIONAL MEDICAL CENTER, 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	273R00000X	Psychiatric Hospital Unit

General Provider Information

NPI Number	:	1972014728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRAND STRAND REGIONAL MEDICAL CENTER, LLC

Provider Business Mailing Address
First Line	:	809 82ND PKWY
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29572-4607
Country	:	US
Telephone Number	:	843-692-1000
Fax Number	:	843-692-1109

Provider Business Practice Location Address
First Line	:	5050 HIGHWAY 17 BYP S
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-4500
Country	:	US
Telephone Number	:	843-692-1000
Fax Number	:	843-692-1109

Authorized Official
Title or Position	:	CFO
Name	:	ROBERT GRACE
Credential	:
Telephone Number	:	843-692-1105

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	11/12/2025

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