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General NPI Number Information
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NPI Number | 1063499952
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Entity Type | Organization
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Legal Business Name | MOBILE RADIOLOGY & EKG OF CAROLINA, INC.
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3575 RUTHERFORD ROAD EXT SUITE D
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City | TAYLORS
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State | SC
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Zip | 29687-2168
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Country | US
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Telephone | 864-268-0013
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Fax | 864-268-0590
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Provider Business Mailing Address
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Address Line | PO BOX 17488
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City | CLEARWATER
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State | FL
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Zip | 33762-0488
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Country | US
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Telephone | 727-443-0389
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Fax | 727-442-7851
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. RANDALL W CARTWRIGHT
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Credential |
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Telephone | 727-443-0389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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