Provider Demographics
NPI:1154025799
Name:OCEANIC PSYCHIATRIC MEDICINE
Entity type:Organization
Organization Name:OCEANIC PSYCHIATRIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-492-7284
Mailing Address - Street 1:PO BOX 16091
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29587-6091
Mailing Address - Country:US
Mailing Address - Phone:833-338-6337
Mailing Address - Fax:843-962-5144
Practice Address - Street 1:11947 GRANDHAVEN DR STE N
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7862
Practice Address - Country:US
Practice Address - Phone:833-338-6337
Practice Address - Fax:843-962-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty