Healthcare Provider Details

I. General information

NPI: 1154387348
Provider Name (Legal Business Name): SANTHILL DIAGNOSTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1249 PEAKE ST
HOLLY HILL SC
29059-2625
US

IV. Provider business mailing address

1249 PEAKE ST
HOLLY HILL SC
29059-2625
US

V. Phone/Fax

Practice location:
  • Phone: 803-496-3389
  • Fax: 803-496-7917
Mailing address:
  • Phone: 803-496-3389
  • Fax: 803-496-7917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MRS. MELISSA K DAVIS
Title or Position: OPERATIONS MANAGER
Credential: CPC
Phone: 803-496-3389