TIDELANDS HEALTH ONCOLOGY – NPI #1629482435
Internal Medicine

An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.

TIDELANDS HEALTH ONCOLOGY is a provider located in GEORGETOWN, SC. NPPES has assigned the NPI number 1629482435 to TIDELANDS HEALTH ONCOLOGY on June 19, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “TIDELANDS HEALTH ONCOLOGY” is a dba name, the actual legal business name for this organization is GEORGETOWN PHYSICIAN ASSOCIATES, LLC. According to the NPI data, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 207RX0202X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Medical Oncology

The NPI profile was previously updated about 6 years ago on Jun 25, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TIDELANDS HEALTH ONCOLOGY below.

NPI Profile for
GEORGETOWN PHYSICIAN ASSOCIATES, LLC

NPI Number
1629482435
Enumeration Date

(about 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Doing Business As (dba): TIDELANDS HEALTH ONCOLOGY
Primary location
2405 N FRASER ST
GEORGETOWN, SC 29440
Phone: (843) 545-7274 Fax: (843) 545-8315
2 Other location(s):
4181 Highway 17
Murrells Inlet, SC 29576-5019
Phone: (843) 652-3600
Fax: (843) 652-3602
1220 21st Ave N
Myrtle Beach, SC 29577-7401
Phone: (843) 652-3600
Fax: (843) 652-8301
Mailing address
PO BOX 421718
GEORGETOWN, SC 29442-4203
Phone: (843) 520-8883 Fax: (843) 652-8422
Organization Subpart
No
Authorized Official
ELIZABETH WARD
EVP & CFO
Phone: (843) 527-7102
Updated
Certification Date
Jun 25, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for TIDELANDS HEALTH ONCOLOGY

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDSCGP7345
MEDICAIDSCGP6530
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RX0202X
- Internal Medicine / Medical Oncology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.