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Kyle Ryan Mcmillen

Student in an Organized Health Care Education/Training Program

Student, Health Care

Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572

PECOS Enrollment

This provider is enrolled in PECOS as KYLE MCMILLEN.

Based on the most recent information from CMS, provider Kyle Ryan Mcmillen is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1336882612
Provider Type
Individual
Full Name
Mcmillen, Kyle Ryan
Gender
Male

Sole Proprietor
No
Enumeration Date
4/15/2022
Last Updated
4/15/2022

Contact Information

Practice Location

Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572

(843) 692-1118

(843) 692-1122

Mailing Location

759 Rose Penny Ln, Spartanburg, SC 29301-6355

(330) 354-3064

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Kyle Ryan Mcmillen

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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