COASTAL CANCER CENTER LLC
NPI 1205856556
Internal Medicine - Hematology & Oncology in Loris, SC
NPI Status: Active since July 20, 2006
Contact Information
3008 BAYBORO ST
LORIS, SC
ZIP 29569
Phone: (843) 756-0932
Fax: (843) 692-5015
- Organization
- Internal Medicine
- Hematology & Oncology
- Accepts Insurance
- CLIA Number: 42D0973322
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-29-2027
About COASTAL CANCER CENTER LLC
This page provides the complete NPI Profile along with additional information for Coastal Cancer Center Llc, an internist established in Loris, South Carolina operating as a Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1205856556 assigned on July 2006. The practitioner's primary taxonomy code is 207RH0003X with license number 11181 (SC). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1205856556
- Provider Legal Name
- COASTAL CANCER CENTER LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 3008 BAYBORO ST LORIS, SC 29569
- Location Phone
- (843) 756-0932
- Location Fax
- (843) 692-5015
- Mailing Address
- 8121 ROURK ST MYRTLE BEACH, SC 29572
- Mailing Phone
- (843) 692-5000
- Mailing Fax
- (843) 692-5015
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-20-2006
- Last Update Date
- 09-02-2025
- Code Navigator
An internist like Coastal Cancer Center Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Hematology & Oncology
- Taxonomy Code
- 207RH0003X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 11181
- License State
- SC
- Taxonomy Description
- An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Bronze with Atrium Health - HMO
- Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
- Focused Silver with Atrium Health - HMO
- Focused Silver with Atrium Health + Vision + Adult Dental - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Standard Expanded Bronze with Atrium Health - HMO
- Blue Direction Bronze 1 - POS
- Blue Direction Silver 1 - POS
- Blue Direction Silver 1 + Adult Vision - POS
- Blue Direction Silver 2 - POS
- Blue Direction Standard Expanded Bronze - POS
- Blue Direction Standard Gold - POS
- Blue Direction Standard Silver - POS
- Blue Pee Dee Bronze 1 - HMO
- Blue Pee Dee Bronze 2 - HMO
- Blue Pee Dee Gold 1 - HMO
- Blue Pee Dee Silver 1 - HMO
- Blue Pee Dee Silver 2 - HMO
- Blue Pee Dee Silver 2 + Adult Vision - HMO
- Blue Pee Dee Standard Expanded Bronze - HMO
- Blue Pee Dee Standard Gold - HMO
- Blue Pee Dee Standard Silver - HMO
- Blue VirtuConnect Bronze 1 - EPO
- Blue VirtuConnect Gold 1 - EPO
- Blue VirtuConnect Silver 1 - EPO
- BlueEssentials Bronze 4 - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| GP2479 | MEDICAID (05) | SC | |
| 7902490 | MEDICAID (05) | NC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D0973322
- Facility Type
- Physician Office
- Certificate Effective Date
- January 30, 2025
- Certificate Expiration Date
- January 29, 2027
- Laboratory Director
- DEJUANIA A. BROWN-RAWLS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Coastal Cancer Center Llc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205856556, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205856556, enumerated as an "organization" on July 20, 2006.
The provider is located at 3008 BAYBORO ST LORIS, SC 29569 and the phone number is (843) 756-0932.
Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.
