| Carolina Forest Urgent Care Llc | |
|
185 Fresh Dr Suite A Myrtle Beach SC 29579-4436 | |
| (843) 945-3030 | |
| (843) 492-4479 |
| Full Name | Carolina Forest Urgent Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 185 Fresh Dr, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Brian K Adler (OWNER) |
| Authorized Official Contact | 8439453030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolina Forest Urgent Care Llc Po Box 51913 Myrtle Beach SC 29579-0032 Ph: (843) 650-4006 | Carolina Forest Urgent Care Llc 185 Fresh Dr Suite A Myrtle Beach SC 29579-4436 Ph: (843) 945-3030 |
| NPI Number | 1295284784 |
|---|---|
| Provider Enumeration Date | 09/26/2016 |
| Last Update Date | 07/06/2021 |
| Medicare PECOS PAC ID | 6507123189 |
|---|---|
| Medicare Enrollment ID | O20171207000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295284784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Joseph V Vandergriff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659474658 PECOS PAC ID: 3072514041 Enrollment ID: I20070118000473 |
| Provider Name | Katie M Hewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851535538 PECOS PAC ID: 8921146077 Enrollment ID: I20091113000015 |
| Provider Name | Alicia Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093075269 PECOS PAC ID: 7012173065 Enrollment ID: I20120719000545 |
| Provider Name | Tara Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801250253 PECOS PAC ID: 5092007021 Enrollment ID: I20160712000565 |
| Provider Name | Rachel Dorr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548811342 PECOS PAC ID: 0547694135 Enrollment ID: I20200108000553 |
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