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Contact Information

COASTAL CAROLINA PHYSICAL REHAB INC
235 SINGLETON RIDGE RD
SUITE 108
CONWAY, SC29526
 Phone: 843-347-4175
 Fax: 843-347-4179
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for COASTAL CAROLINA PHYSICAL REHAB INC

NPI Number 1932344454
LBN Legal business name COASTAL CAROLINA PHYSICAL REHAB INC
Authorized official MAYRA ALFONSO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/12/2008
Last updated 12/12/2008 - About 17 years ago
Identifiers
SC License # MD21577
Other MD21577 SC MEDICAL LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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