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FAMILY FIRST HEALTH CLINIC PA NPI 1285288225


NPI Information

NPI: 1285288225
Provider Name: FAMILY FIRST HEALTH CLINIC, PA
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D2173221

Address:
4612 OLEANDER DR STE 102
MYRTLE BEACH, SC
ZIP 29577
Phone: (843) 945-8117
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FAMILY FIRST HEALTH CLINIC, PA is a family medicine in Myrtle Beach, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FAMILY FIRST HEALTH CLINIC, PA NPI is 1285288225. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4612 OLEANDER DR STE 102
MYRTLE BEACH, SC
ZIP 29577-711
Phone: (843) 945-8117
Fax: (843) 945-8124

The provider's authorized official is Chrystal M Coates-gal .
The authorized official title is President/owner and has the following contact phone number (843) 945-8117.

The CLIA number assigned to this NPI record is 42D2173221 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/29/2019 and was last updated on 6/15/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes
2363LF0000XNurse PractitionerFamilyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1378460MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.