National Provider Identifier Database

CAPESIDE ADDICTION CARE PLLC
Addiction Medicine

A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine


Contact Information

CAPESIDE ADDICTION CARE, PLLC
4889 HIGHWAY 17 BYP S
MYRTLE BEACH, SC29577-6683
Phone: 843-584-7011
Fax: 843-945-1355
Website:
Specialty Taxonomy Code
* Addiction Medicine 2084A0401X

* Indicates primary specialty

NPI Profile & details for CAPESIDE ADDICTION CARE, PLLC

NPI Number 1093280620
Legal business name
LBN
CAPESIDE ADDICTION CARE, PLLC
Authorized official WILLIAM BEASLEY - (CHIEF OPERATING OFFICER)
Entity Organization
Organization subpart No
Enumeration date 10/10/2018
Last updated 10/10/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • NC Medicaid: 1255323622

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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