Provider Demographics
NPI:1942252192
Name:STRANDCARE
Entity Type:Organization
Organization Name:STRANDCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:TURBEVILLE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:843-662-8887
Mailing Address - Street 1:PO BOX 6708
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-6708
Mailing Address - Country:US
Mailing Address - Phone:843-662-8887
Mailing Address - Fax:843-662-9920
Practice Address - Street 1:179 PRATHER PARK DR
Practice Address - Street 2:UNIT A
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7949
Practice Address - Country:US
Practice Address - Phone:843-236-6797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAROLINA MEDCARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-16
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDHEC 2003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAB0252Medicaid
SCAB0252Medicaid
SCP00432948Medicare PIN