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NPI Code Detail

MEDICARE: MANNING DIAGNOSTICS LLC

MEDICARE: MANNING DIAGNOSTICS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225291206
Entity Type Code : Organization
Provider Name (Legal Business Name) : MANNING DIAGNOSTICS LLC
Provider Business Mailing Address
First Line : 202 E HOSPITAL ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3160
Country : US
Telephone Number : 803-433-2021
Fax Number :
Provider Business Practice Location Address
First Line : 202 E HOSPITAL ST
Second Line :
City : MANNING
State : SC
Zip : 29102-3160
Country : US
Telephone Number : 803-433-2021
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : MELISSA K DAVIS
Credential :
Telephone Number : 843-771-4031
Provider Enumeration Date : 07/09/2008
Last Update Date : 07/09/2008

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Directions to “MANNING DIAGNOSTICS LLC ” Practice Location

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