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NPI 1003645748

NPI 1003645748 : AMERICAN HEALTH IMAGING OF SOUTH CAROLINA LLC : GREENVILLE, SC

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General NPI Number Information
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    NPI Number           |    1003645748
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMERICAN HEALTH IMAGING OF SOUTH CAROLINA LLC 
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Dates
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    Enumeration Date     |    07/31/2024
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    Last Update Date     |    08/08/2024
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Provider Practice Location Address
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    Address Line         |    1306 S CHURCH ST STE 200 
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    City                 |    GREENVILLE
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    State                |    SC
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    Zip                  |    29605-3851
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    Country              |    US
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    Telephone            |    704-334-7800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    700 E MOREHEAD ST STE 300 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28202-2742
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    Country              |    US
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    Telephone            |    704-334-7800
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR OF CREDENTIALING
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    Name                 |     KATRINA  ROELLE 
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    Credential           |    
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    Telephone            |    614-689-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QR0200X
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    Taxonomy Name        |    Radiology Clinic/Center
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    License Number       |    
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    License Number State |    
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