Healthcare Provider Details

I. General information

NPI: 1386919082
Provider Name (Legal Business Name): ARTERIAL IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712 MIDDLEBURG DR SUITE 220
COLUMBIA SC
29204-2415
US

IV. Provider business mailing address

2712 MIDDLEBURG DR SUITE 220
COLUMBIA SC
29204-2415
US

V. Phone/Fax

Practice location:
  • Phone: 803-315-7425
  • Fax: 803-343-2112
Mailing address:
  • Phone: 803-315-7425
  • Fax: 803-343-2112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. DON L BUNDRICK
Title or Position: PRESIDENT
Credential:
Phone: 803-343-2133