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General NPI Number Information
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NPI Number | 1164846010
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Entity Type | Organization
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Legal Business Name | SOUTHERN DIAGNOSTIC IMAGING, INC.
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Dates
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Enumeration Date | 02/13/2014
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 10 PARKSIDE PL
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City | ASHEVILLE
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State | NC
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Zip | 28804-1324
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Country | US
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Telephone | 828-258-1088
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Fax |
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Provider Business Mailing Address
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Address Line | 10 PARKSIDE PL
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City | ASHEVILLE
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State | NC
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Zip | 28804-1324
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Country | US
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Telephone | 828-258-1088
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, SDI
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Name | MRS. RUTH M BATTLE
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Credential | RDCS, RVT, RDMS
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Telephone | 828-258-1088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number | 26939
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License Number State | NC
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