OrganizationActive
Coastal Carolina Medical Center, Inc
NPI 1124307509 · Rural Health Clinic/Center · Ridgeland, SC
Provider details
- NPI number
- 1124307509
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ron Groteluschen, Cfo(843) 784-8076
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10911 N Jacob Smart Blvd
D
Ridgeland, SC 29936-2729
Phone: (843) 784-3101
Fax: (843) 784-5313
Street-level locationGet directions
Mailing address
Po Box 741261
Atlanta, GA 30374-1261
Other names (DBA / former)
- Doing business as
- Coastal Medical Associates
- Doing business as
- Coastal Medical Associates
Registry dates
- Enumerated
- 2011-08-16
- Last updated
- 2022-03-22
- Certified
- 2022-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.