NPI | 1184195158 |
---|---|
Entity Type | Organization |
Authorized Contact | LATONYA D SANDERS-MILLER Phlebotomist 843-957-8782 |
Organization Subpart ? | No |
Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
Additional Taxonomies | 347C00000X Private Vehicle |
251E00000X Home Health | |
251S00000X | |
261QC1500X Clinic/Center, Community Health | |
302F00000X Exclusive Provider Organization | |
305S00000X Point of Service | |
335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
Enumeration Date | 2018-12-17 |
Last Update Date | 2022-01-18 |