COASTAL CANCER CENTER, LLC
NPI 1336169531
Internal Medicine - Hematology & Oncology in Murrells Inlet, SC
- Organization
- Internal Medicine
- Hematology & Oncology
- Accepts Insurance
- Medicare Supplier
- Accepts Medicare Approved Payment
- CLIA Number: 42D0699945
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 02-23-2027
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 Murrells Inlet, South Carolina operating as a Internal Medicine, focusing in hematology & oncology . The healthcare provider is registered in the NPI registry with number 1336169531 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 authorized official of this NPI record is Dr. Vijay Paudel Md (Partner)
- NPI
- 1336169531 Verify this NPI
- Provider Name
- COASTAL CANCER CENTER, LLC
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 4620 HIGHWAY 17 MURRELLS INLET, SC 29576
- Location Phone
- (843) 357-7357
- 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?
- Yes
- 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.
Coastal Cancer Center, Llc is a medicare supplier with PTAN 20666621 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Immunosuppressive Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or External Infusion Pumps and/or Supplies.
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:
- 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 |
|---|---|---|---|
| GP2749 | MEDICAID (05) | SC | |
| 8902481 | MEDICAID (05) | NC |
Medical Equipment Supplier
The provider carries the following medical supplies product categories:
- PTAN
- 20666621
- Accepts Medicare Assignment
- YES
- Specialities List
- Pharmacy.
- Provider Type List
- PHYSICIAN – HEMATOLOGY/ONCOLOGY.
- Competitive Bidding
- NO
Supplies List
- Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
- Oral Anticancer Drugs - FDA anticancer drugs
- Oral Antiemetic Drugs - FDA antiemetic drugs
- External Infusion Pumps and/or Supplies - An infusion pump is necessary to safely administer the drug
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
- 42D0699945
- Facility Type
- Physician Office
- Certificate Effective Date
- February 24, 2025
- Certificate Expiration Date
- February 23, 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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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1336169531, enumerated as an "organization" on July 20, 2006.
The provider is located at 4620 HIGHWAY 17 MURRELLS INLET, SC 29576 and the phone number is (843) 357-7357.
Internal Medicine with taxonomy code 207RH0003X and a focus in Hematology & Oncology.
The provider might be accepting Accepts: BlueCross BlueShield of South Carolina, Medicare. Please consult your insurance carrier or call the provider to verify.
