Atlantic Urology Clinic LLC

Organization Active NPI Non-Pharmacy Dispensing Site · Conway, SC

NPI 1962157693 · NPPES record last updated Feb 22, 2022

Key facts

NPI
1962157693
Entity type
Organization (NPI type 2)
Primary specialty
Non-Pharmacy Dispensing Site 332900000X
Legal business name
ATLANTIC UROLOGY CLINIC LLC
Practice address
135 Professional Park Dr
Conway, SC 29526-9261
Phone
(843) 347-2450
NPI assigned
Feb 22, 2022
Organization subpart
Yes
Parent organization (as reported)
ATLANTIC UROLOGY CLINIC LLC

Authorized official

Name
Debbie L Bolig
Title
Director of Revenue Cycle
Phone
(843) 347-2450

Corporate family (same tax ID) 4

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Atlantic Urology Clinic (5 organizations share this tax ID)
Part of
Atlantic Urology Clinic

Locations

135 Professional Park Dr
Conway, SC 29526
Phone (843) 347-8765

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Yes

Addresses

Primary practice location

135 Professional Park Dr
Conway, SC 29526-9261

Mailing address

611 Burroughs and Chapin Blvd Ste 105
Myrtle Beach, SC 29577-3200
Phone (843) 347-2450

Other names

  • IOD-CUC Other name

Other providers in Conway, SC

All providers in Conway, SC · Non-Pharmacy Dispensing Site in South Carolina

Sources for this page

Verify at the official NPI Registry.