Georgetown Physician Associates, LLC
Organization Active NPI Urgent Care Clinic/Center · Murrells Inlet, SC
NPI 1295113207 · NPPES record last updated May 1, 2020
Key facts
- NPI
- 1295113207
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- GEORGETOWN PHYSICIAN ASSOCIATES, LLC
- Practice address
- 4040 Highway 17
Suite 105
Murrells Inlet, SC 29576 - Phone
- (843) 652-8090
- Fax
- (843) 652-8091
- NPI assigned
- May 11, 2015
- Organization subpart
- No
Authorized official
- Name
- Elizabeth Sutherland Ward
- Title
- Evp & Cfo
- Phone
- (843) 527-7102
Other NPIs on the same Medicare enrollment 30
Member organizations 3
Practitioners 2
-
Earl James Han, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130225000067 | SC | Part B Supplier - Clinic/Group Practice | 2365697398 |
Receives reassigned benefits from 302 practitioners 30 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Murrells Inlet, SC; Myrtle Beach, SC; Pawleys Island, SC; Andrews, SC; Georgetown, SC; Hemingway, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | SC | Yes |
Addresses
Primary practice location
4040 Highway 17
Suite 105
Murrells Inlet, SC 29576
Mailing address
PO Box 421718
Georgetown, SC 29442-4203
Phone (843) 520-8883
Other names
- Tidelands Urgent Care
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | WWW.TIDELANDSHEALTH.ORG |
Other providers in Murrells Inlet, SC
- Georgetown Physician Associates
- Georgetown Physician Associates LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
- Georgetown Physician Associates, LLC
All providers in Murrells Inlet, SC · Urgent Care Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.