Provider Demographics
NPI:1912937624
Name:HILTON HEAD HEALTH SYSTEM, L.P.
Entity Type:Organization
Organization Name:HILTON HEAD HEALTH SYSTEM, L.P.
Other - Org Name:HILTON HEAD HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTELUSCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-689-8101
Mailing Address - Street 1:PO BOX 741204
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-1204
Mailing Address - Country:US
Mailing Address - Phone:678-242-2002
Mailing Address - Fax:843-689-3670
Practice Address - Street 1:25 HOSPITAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2738
Practice Address - Country:US
Practice Address - Phone:843-681-6122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC646282N00000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
200299OtherBCBS SOUTH CAROLINA
420080B000000OtherSECTION 1011
479313OtherAETNA US HEALTHCARE
7206OtherCOVENTRY HEALTH CARE GROU
359205480OtherAETNA US HEALTHCARE
SC388966Medicaid
SC457520Medicaid
161888OtherCOVENTRY HEALTH CARE GROU
SC457520Medicaid
359205480OtherAETNA US HEALTHCARE