Healthcare Provider Details

I. General information

NPI: 1063561884
Provider Name (Legal Business Name): SOUND MEDICAL SYSTEMS ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 WILD AZALEA CT
LEXINGTON SC
29072-8858
US

IV. Provider business mailing address

205 WILD AZALEA CT
LEXINGTON SC
29072-8858
US

V. Phone/Fax

Practice location:
  • Phone: 803-957-5260
  • Fax: 803-957-4575
Mailing address:
  • Phone: 803-957-5260
  • Fax: 803-957-4575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XS1301X
TaxonomySonography Specialist/Technologist Cardiovascular
License Number94352
License Number StateSC

VIII. Authorized Official

Name: MR. JIMMY WELDON CONNOR
Title or Position: OWNER
Credential: RDCS,RVT
Phone: 803-957-5260