Healthcare Provider Details
I. General information
NPI: 1023044591
Provider Name (Legal Business Name): COMPLETE HEALTH DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2006
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8807 TWO NOTCH RD
COLUMBIA SC
29223-6522
US
IV. Provider business mailing address
4550 N POINT PKWY SUITE 220
ALPHARETTA GA
30022-2445
US
V. Phone/Fax
- Phone: 803-865-1610
- Fax: 803-865-1136
- Phone: 770-777-1868
- Fax: 770-777-1872
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 247200000X |
| Taxonomy | Other Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SCOTT
A.
HUNTER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 770-777-1868