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General NPI Number Information
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NPI Number | 1093953150
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Entity Type | Organization
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Legal Business Name | SHULER MOBILE X-RAY SERVICE
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Dates
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Enumeration Date | 01/28/2009
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Last Update Date | 01/28/2009
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Provider Practice Location Address
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Address Line | 3421 KAY ST SUITE U5
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City | COLUMBIA
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State | SC
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Zip | 29210-5373
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Country | US
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Telephone | 803-477-5366
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Fax |
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Provider Business Mailing Address
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Address Line | 3421 KAY ST SUITE U5
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City | COLUMBIA
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State | SC
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Zip | 29210-5373
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Country | US
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Telephone | 803-477-5366
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Fax |
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Authorized Official
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Title or Position | REGISTERED X-RAY TECHNOLOGIST
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Name | MR. EDDIE T SHULER RT( R )
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Credential |
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Telephone | 803-477-5366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 00-2769 X-RAY TECH
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License Number State | SC
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