Provider Demographics
NPI:1528561453
Name:SEA ISLAND MEDICAL CARE
Entity Type:Organization
Organization Name:SEA ISLAND MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-252-1150
Mailing Address - Street 1:2114 HIGHWAY 41 STE 105
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-6204
Mailing Address - Country:US
Mailing Address - Phone:843-388-9000
Mailing Address - Fax:843-388-6937
Practice Address - Street 1:2114 HIGHWAY 41
Practice Address - Street 2:SUITE 105
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:843-388-9000
Practice Address - Fax:843-388-6937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-16
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
1326141938OtherNPI
1982116331OtherNPI
1164427811OtherNPI
1932437662OtherNPI