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General NPI Number Information
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NPI Number | 1093366056
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Entity Type | Organization
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Legal Business Name | SIMPLY ME INFUSION CENTER LLC
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Dates
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Enumeration Date | 09/21/2019
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Last Update Date | 09/21/2019
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Provider Practice Location Address
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Address Line | 1601 N OAK ST STE 307
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-3579
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Country | US
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Telephone | 843-400-3009
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Fax | 843-448-0048
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Provider Business Mailing Address
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Address Line | 1601 N OAK ST STE 307
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-3579
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Country | US
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Telephone | 843-400-3009
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Fax | 843-448-0048
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/OWNER
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Name | DR. JANA MCKENZIE
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Credential | DO
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Telephone | 843-400-3009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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