NPIMap

Organization Active NPI

Beachside Clinic Inc

  • Prosthetic/Orthotic Supplier
  • Myrtle Beach, SC
National Provider Identifier
1154665644
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
BEACHSIDE CLINIC INC
Practice address
931 Medical Cir
Myrtle Beach, SC 29572-4122
Phone
(843) 877-5224
NPI assigned
Nov 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Bradley C Hornick
Title
Owner
Phone
(842) 877-5224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

931 Medical Cir
Myrtle Beach, SC 29572-4122

Mailing address

931 Medical Cir
Myrtle Beach, SC 29572-4122
Phone (843) 877-5224

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353456000000",
    "number": "1154665644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724122",
            "telephone_number": "843-877-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724122",
            "telephone_number": "843-877-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHSIDE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-21",
        "status": "A",
        "authorized_official_last_name": "HORNICK",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "842-877-5224",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.