Coastal Carolina Medical Center, Inc.

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

HTL-902 Issued in SC

Legal business name

COASTAL CAROLINA MEDICAL CENTER, INC.

Doing business as

Coastal Carolina Hospital

Practice address

1000 Medical Center Dr
Hardeeville, SC 29927-3446

Phone

(834) 784-8000

Fax

(834) 784-8001

NPI assigned

Jan 25, 2006

Last updated

Mar 22, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ron Groteluschen

Title

Cfo

Phone

(843) 784-8076

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Coastal Carolina Hospital Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647907200000",
    "number": "1962472431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741261",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741261",
            "telephone_number": "834-784-8000",
            "fax_number": "834-784-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER DR",
            "city": "HARDEEVILLE",
            "state": "SC",
            "postal_code": "299273446",
            "telephone_number": "834-784-8000",
            "fax_number": "834-784-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CAROLINA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A",
        "authorized_official_last_name": "GROTELUSCHEN",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "843-784-8076"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "SC",
            "license": "HTL-902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A00877",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B00877",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "CCD@Direct.Hub4.TenetHealth.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1000 Medical Center Dr",
            "city": "Hardeeville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299273446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coastal Carolina Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Carolina Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Coastal Carolina Medical Center, Inc. (Coastal Carolina Hospital)
• Coastal Carolina Physician Practices LLC
• Coastal Carolina Physician Practices LLC (Coastal Carolina Ear Nose and Throat)
• Coastal Carolina Urology Group LLC
• Coastal Emergency Group, PC
• Coastal Empire Imaging, LLC

• General Acute Care Hospital in Hardeeville, SC
• Providers in Hardeeville, SC by specialty
• General Acute Care Hospital in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; 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.