Healthcare Provider Details

I. General information

NPI: 1821240300
Provider Name (Legal Business Name): TLM MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1707 BERNARDIN AVE SUITE C
COLUMBIA SC
29204-2004
US

IV. Provider business mailing address

PO BOX 1317
COLUMBIA SC
29202-1317
US

V. Phone/Fax

Practice location:
  • Phone: 803-376-8875
  • Fax: 803-376-8004
Mailing address:
  • Phone: 803-376-8875
  • Fax: 803-376-8004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number22363
License Number StateSC

VIII. Authorized Official

Name: DR. CONIGLIARO JONES
Title or Position: PHYSICIAN/PRESIDENT
Credential: M.D.
Phone: 803-376-8875