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General NPI Number Information
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NPI Number | 1619159068
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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 | 11/28/2007
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Last Update Date | 09/19/2013
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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 | 2400 E COMMERCIAL BLVD SUITE 826
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4054
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Country | US
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Telephone | 954-510-3700
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Fax | 954-510-2649
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Authorized Official
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Title or Position | CEO
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Name | MR. ROBERT E ADAMS
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Credential |
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Telephone | 954-510-3703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 42D1060447
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License Number State | SC
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