| Executive Court Medical Specialist P.c. | |
|
997 Hwy 17 Business South Suite C Surfside Beach SC 29575-6084 | |
| (843) 839-4505 | |
| (843) 839-2851 |
| Full Name | Executive Court Medical Specialist P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 997 Hwy 17 Business South, Surfside Beach, South Carolina |
| Authorized Official Name and Position | Janet Faye Buchanan (OFFICE MANAGER) |
| Authorized Official Contact | 8438394505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Executive Court Medical Specialist P.c. 4701 Oleander Drive Suite B Myrtle Beach SC 29577 Ph: (843) 497-6301 | Executive Court Medical Specialist P.c. 997 Hwy 17 Business South Suite C Surfside Beach SC 29575-6084 Ph: (843) 839-4505 |
| NPI Number | 1558575217 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/26/2008 |
| Medicare PECOS PAC ID | 5092740449 |
|---|---|
| Medicare Enrollment ID | O20051004000931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558575217 | NPI | - | NPPES |
| GP0772 | Medicaid | SC | |
| 1558345686 | Other | SC | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 15450 (South Carolina) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 15451 (South Carolina) | Primary |
| Provider Name | Rhonda G Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730176504 PECOS PAC ID: 2567376650 Enrollment ID: I20031113000416 |
| Provider Name | John E Rathbun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558345686 PECOS PAC ID: 3779518121 Enrollment ID: I20120216000355 |
James M. Vest, Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4700 S Ocean Blvd, Surfside Beach, SC 29575 Phone: 843-238-8747 Fax: 843-232-8401 | |
Surfside Beach Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 Glenns Bay Rd, Surfside Beach, SC 29575 Phone: 843-650-4006 Fax: 843-650-4225 | |
Primary Medical, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1413 Highway 17 N, Surfside Beach, SC 29575 Phone: 843-238-5654 Fax: 843-238-1624 | |
Terry Reardon Md, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 600 N Azalea Dr Ste 104, Surfside Beach, SC 29575 Phone: 843-360-2776 Fax: 877-905-5374 | |
James M Vest Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4700 S Ocean Blvd, Surfside Beach, SC 29575 Phone: 843-238-8747 Fax: 843-232-8401 | |
Ssi Admin, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1945 Glenns Bay Rd, Suite B, Surfside Beach, SC 29575 Phone: 843-650-4006 Fax: 843-650-4019 |