Healthcare Provider Details

I. General information

NPI: 1588707897
Provider Name (Legal Business Name): THE IMAGING CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 04/02/2008
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

6729 LONGBROOK RD
COLUMBIA SC
29206
US

V. Phone/Fax

Practice location:
  • Phone: 803-343-2133
  • Fax: 803-343-2112
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

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