| Strand Regional Specialty | |
|
3617 Casey St Suite D Loris SC 29569-2981 | |
| (834) 756-9729 | |
| (843) 390-0038 |
| Full Name | Strand Regional Specialty |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3617 Casey St, Loris, South Carolina |
| Authorized Official Name and Position | Kim Smith (ADMINISTRATOR) |
| Authorized Official Contact | 8436922167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Strand Regional Specialty Po Box 100523 Florence SC 29501-0523 Ph: (843) 669-5162 | Strand Regional Specialty 3617 Casey St Suite D Loris SC 29569-2981 Ph: (834) 756-9729 |
| NPI Number | 1366469397 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366469397 | NPI | - | NPPES |
| 1819815 | Medicaid | PA | |
| 5599938 | Other | NY | GHI |
| GP3642 | Medicaid | SC | |
| 790167K | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QR0200X | Clinic/center - Radiology | (* (Not Available)) | Secondary |
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