Mr Blaine B Rourke, DO in Myrtle Beach, SC - Medicare Student in an Organized Health Care Education/Training Program

Mr Blaine B Rourke, DO is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Myrtle Beach, South Carolina. His current practice location is 809 82nd Pkwy, Myrtle Beach, South Carolina. You can reach out to his office (for appointments etc.) via phone at (843) 692-1752.

Mr Blaine B Rourke is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184640740.

Contact Information

	Mr Blaine B Rourke, DO
	809 82nd Pkwy, Myrtle Beach, SC 29572-4607
	(843) 692-1752
	(843) 692-1904

Provider's Profile

Full Name	Mr Blaine B Rourke
Gender	Male
Speciality	Student In An Organized Health Care Education/training Program
Location	809 82nd Pkwy, Myrtle Beach, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184640740
Provider Enumeration Date: 07/15/2006
Last Update Date: 03/28/2021

Medicare PECOS Information:

PECOS PAC ID: 8820078058
Enrollment ID: I20131122001139

Medical Identifiers

Medical identifiers for Mr Blaine B Rourke such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184640740	NPI	-	NPPES
8L5723	Other	TX	MEDICARE PTAN
182196901	Medicaid	TX

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA03254 (Texas)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blaine B Rourke is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Blaine B Rourke, DO 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 Ph: (843) 692-1752	Mr Blaine B Rourke, DO 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 Ph: (843) 692-1752

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Mr Blaine B Rourke, DO - Medicare Student in an Organized Health Care Education/Training Program in Myrtle Beach, SC