Healthcare Provider Details

I. General information

NPI: 1487964359
Provider Name (Legal Business Name): POPE DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2010
Last Update Date: 10/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 RICE BENT WAY UNIT 12
COLUMBIA SC
29229-6849
US

IV. Provider business mailing address

101 RICE BENT WAY UNIT 12
COLUMBIA SC
29229-6849
US

V. Phone/Fax

Practice location:
  • Phone: 843-812-5988
  • Fax: 877-903-1383
Mailing address:
  • Phone: 843-812-5988
  • Fax: 877-903-1383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number StateSC

VIII. Authorized Official

Name: MR. DWYANE POPE
Title or Position: OWNER
Credential: RVS/RCS
Phone: 843-812-5988