| Capeside Addiction Care, Pllc | |
|
4889 Highway 17 Byp S Myrtle Beach SC 29577-6683 | |
| (843) 584-7011 | |
| (843) 945-1355 |
| Full Name | Capeside Addiction Care, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Medicine |
| Location | 4889 Highway 17 Byp S, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | William Beasley (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 9107916767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capeside Addiction Care, Pllc 311 4 E Judges Road Wilmington NC 28405 Ph: (910) 791-6767 | Capeside Addiction Care, Pllc 4889 Highway 17 Byp S Myrtle Beach SC 29577-6683 Ph: (843) 584-7011 |
| NPI Number | 1093280620 |
|---|---|
| Provider Enumeration Date | 10/10/2018 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093280620 | NPI | - | NPPES |
| 1255323622 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
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