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General NPI Number Information
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NPI Number | 1104889377
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Entity Type | Organization
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Legal Business Name | INMED DIAGNOSTICS SERVICES OF SC LLC
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 126 S ASSEMBLY ST
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City | COLUMBIA
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State | SC
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Zip | 29201-4545
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Country | US
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Telephone | 803-988-0082
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Fax | 803-988-0095
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Provider Business Mailing Address
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Address Line | PO BOX 593869
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City | ORLANDO
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State | FL
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Zip | 32859-3869
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Country | US
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Telephone | 352-241-6100
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Fax | 352-241-6101
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Authorized Official
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Title or Position | COMPLIANCE & CREDENTIALING MANAGER
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Name | CARMEN RESTIVO
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Credential |
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Telephone | 352-241-6100
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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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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 19347
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License Number State | SC
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