| North Myrtle Beach Family Practice | |
|
86 Cedar Ave North Myrtle Beach SC 29582-3112 | |
| (843) 249-2451 | |
| (843) 249-4100 |
| Full Name | North Myrtle Beach Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 86 Cedar Ave, North Myrtle Beach, South Carolina |
| Authorized Official Name and Position | John Garnett Ramslattorn (PRESIDENT) |
| Authorized Official Contact | 8432492451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Myrtle Beach Family Practice 86 Cedar Ave North Myrtle Beach SC 29582-3112 Ph: (843) 249-2451 | North Myrtle Beach Family Practice 86 Cedar Ave North Myrtle Beach SC 29582-3112 Ph: (843) 249-2451 |
| NPI Number | 1619014487 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 03/05/2008 |
| Medicare PECOS PAC ID | 0941481048 |
|---|---|
| Medicare Enrollment ID | O20110223000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619014487 | NPI | - | NPPES |
| 092642 | Medicaid | SC | |
| 29670 | Other | SC | MEDCAST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9264 (South Carolina) | Primary |
| Provider Name | John Garnett Ramsbottom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437277753 PECOS PAC ID: 7911188016 Enrollment ID: I20110223000187 |
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