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General NPI Number Information
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NPI Number | 1154387348
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Entity Type | Organization
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Legal Business Name | SANTHILL DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 1249 PEAKE ST
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City | HOLLY HILL
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State | SC
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Zip | 29059-2625
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Country | US
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Telephone | 803-496-3389
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Fax | 803-496-7917
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Provider Business Mailing Address
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Address Line | 1249 PEAKE ST
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City | HOLLY HILL
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State | SC
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Zip | 29059-2625
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Country | US
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Telephone | 803-496-3389
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Fax | 803-496-7917
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MRS. MELISSA K DAVIS
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Credential | CPC
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Telephone | 803-496-3389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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