COASTAL CAROLINA UNIVERSITY STUDENT HEALTH SERVICES (NPI# 1083800858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083800858 |
| Entity Type | Organization |
| Organization Name | COASTAL CAROLINA UNIVERSITY STUDENT HEALTH SERVICES |
| Practice Address |
204 University Blvd Conway SC 29526-8834 |
| Mailing Address |
Po Box 261954 Conway SC 29528-6054 |
| Practice Telephone | 8433496543 |
| Mailing Telephone | 8433496543 |
| Mailing Fax Number | 8433496546 |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |
| Authorized Official Name | MR. CAESAR ROSS (DIRECTOR) |
| Authorized Official Telephone | 8433496543 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
27353 | SC | Ambulatory Health Care Facilities |
| Street Address |
204 UNIVERSITY BLVD |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-8834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609085919 | Jonathan Michael Glass | Counselor | 204 University Blvd, Conway, SC 29526-8834 | 2007-05-22 |
| 1710136908 | Coastal Carolina University | Clinic/Center | 204 University Blvd, Conway, SC 29526-8834 | 2008-09-12 |
| 1972765477 | Jennifer O Kuperman | Internal Medicine | 204 University Blvd, Conway, SC 29526-8834 | 2008-06-26 |
| 1417144072 | Tonya Renell Mckenzie | Nurse Practitioner | 204 University Blvd, Conway, SC 29526-8834 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528459799 | Myra Jo Grantham | Clinic/Center | 2302 College Ave, Conway, AR 72034-6297 | 2015-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669950903 | Medical University of South Carolina | Clinic/Center | 30 Bee St Ste 102, Charleston, SC 29425-8910 | 2018-07-30 |
| 1083916647 | Usc Upstate | Clinic/Center | 995 University Way, Usc Upstate Health Services, Spartanburg, SC 29303-4932 | 2010-12-02 |
| 1720256316 | Winthrop University | Clinic/Center | 217 Crawford Building, Crawford Building, Rock Hill, SC 29733-7001 | 2008-02-15 |
| 1699816199 | Winthrop University Health Services Pharmacy | Clinic/Center | 701 Oakland Ave, Crawford Bldg, Rock Hill, SC 29733-7001 | 2007-02-09 |
| 1740293422 | University of South Carolina | Clinic/Center | U S C Student Health Ctr, Columbia, SC 29208-0001 | 2006-08-14 |
| 1265404743 | Abbeville County School District | Clinic/Center | 400 Greenville St., Abbeville, SC 29620 | 2006-02-07 |
| 1598382152 | Rafael Mojica | Clinic/Center | 350 Howard St, Spartanburg, SC 29303-3515 | 2020-06-30 |
| 1285068544 | University of South Carolina Aiken | Clinic/Center | 471 University Pkwy, Box 11, Aiken, SC 29801-6389 | 2013-08-22 |
| 1437434297 | Wofford College | Clinic/Center | 429 N Church St, Spartanburg, SC 29303-3612 | 2011-10-12 |
| 1053437301 | Clemson University-redfern Health Center | Clinic/Center | 735 Mcmillan Rd, Clemson University, Clemson, SC 29634-0001 | 2007-03-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COASTAL CAROLINA UNIVERSITY STUDENT HEALTH SERVICES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.