Source Diagnostics of South Carolina, LLC

NPI #1245590140 in North Myrtle Beach, South Carolina

Provider Information

NPI Number: 1245590140
Entity Type: Organization
Organization Name: Source Diagnostics of South Carolina, LLC
Primary Specialty: Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Enumeration Date: May 24, 2012
Last Updated: May 24, 2012

Practice Location

Address: 2701 S OCEAN BLVD
Address 2: UNIT 1831
City: North Myrtle Beach
State: South Carolina
ZIP Code: 29582-4641
Phone: (440) 645-7822

Authorized Official

Name: KATHLEEN A BARRY
Title: COO
Phone: (440) 645-7822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier	335V00000X	Primary

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