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Contact Information

DIRECT DIAGNOSTIC SERVICES, LLC
4 CARRIAGE LN STE 108
CHARLESTON, SC29407-6048
 Phone: 828-396-5634
 Fax: 888-818-8707
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physiological Laboratory, (Independent Physiological Lab)

293D00000X 47 Independent Diagnostic Testing Facility (IDTF)
 

Radiology

261QR0200X 74 Radiation Therapy Center
Indicates primary specialty

NPI Profile & details for DIRECT DIAGNOSTIC SERVICES, LLC

NPI Number 1801040274
LBN Legal business name DIRECT DIAGNOSTIC SERVICES, LLC
Authorized official PAMELA QUEEN - (MEMBER MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/11/2008
Last updated 05/05/2021 - About 5 years ago
Identifiers
NC Medicaid 8105053
SC Medicaid SL0105
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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