| Broadway Medical Innovation, Llc | |
|
100 Water Grande Blvd Little River SC 29566 | |
| (843) 655-0004 | |
| Not Available |
| Full Name | Broadway Medical Innovation, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 Water Grande Blvd, Little River, South Carolina |
| Authorized Official Name and Position | Victor Aguin Melendez (OWNER) |
| Authorized Official Contact | 8436550004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Medical Innovation, Llc 4016 River Oaks Dr Ste 6 Pmb 178 Myrtle Beach SC 29579-6674 Ph: (843) 655-0004 | Broadway Medical Innovation, Llc 100 Water Grande Blvd Little River SC 29566 Ph: (843) 655-0004 |
| NPI Number | 1467108514 |
|---|---|
| Provider Enumeration Date | 02/28/2022 |
| Last Update Date | 04/22/2026 |
| Medicare PECOS PAC ID | 4981091923 |
|---|---|
| Medicare Enrollment ID | O20220421002723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467108514 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lindsey D States |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457668386 PECOS PAC ID: 7719161207 Enrollment ID: I20110407000229 |
| Provider Name | Mary Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639557531 PECOS PAC ID: 3971819608 Enrollment ID: I20150826001232 |
| Provider Name | Victor J Aguin Melendez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538563903 PECOS PAC ID: 6305160193 Enrollment ID: I20171025001236 |
| Provider Name | Matthew David Zeuschner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629684576 PECOS PAC ID: 3577977487 Enrollment ID: I20210203002283 |
Palmetto Care Health And Mental Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1304 Highway 17, Little River, SC 29566 Phone: 843-278-0098 | |
Loris Community Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3980 Highway 9 E, Suite 100, Little River, SC 29566 Phone: 843-390-8320 Fax: 843-390-8329 | |
Mcleod Physician Associates Ii Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3793 Mcdowell Lane, Suite 100, Little River, SC 29566 Phone: 843-390-0100 Fax: 843-390-0038 | |
Strand Regional Specialty Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4000 Highway 9 E, Suite 215, Little River, SC 29566 Phone: 843-390-0033 Fax: 843-390-0038 | |
Waterway Primary Care,llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3600 Sea Mountain Hwy, Little River, SC 29566 Phone: 843-399-4848 | |
Little River Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4303 Live Oak Dr, Little River, SC 29566 Phone: 843-663-1013 Fax: 843-663-1017 |