Healthcare Provider Details

I. General information

NPI: 1174788293
Provider Name (Legal Business Name): FNS IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 06/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

IV. Provider business mailing address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

V. Phone/Fax

Practice location:
  • Phone: 843-673-0122
  • Fax: 843-673-0227
Mailing address:
  • Phone: 843-673-0122
  • Fax: 843-673-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GALE DEAVER
Title or Position: OFFICE MANAGER
Credential:
Phone: 843-673-0122