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Contact Information

SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC
2701 S OCEAN BLVD
UNIT 1831
NORTH MYRTLE BEACH, SC29582-4641
 Phone: 440-645-7822
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Portable Xray Supplier

335V00000X 63 Portable X-Ray Supplier
Indicates primary specialty

NPI Profile & details for SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC

NPI Number 1245590140
LBN Legal business name SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC
Authorized official KATHLEEN BARRY - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 05/24/2012
Last updated 05/24/2012 - About 14 years ago
Identifiers n/a
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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