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General NPI Number Information
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NPI Number | 1932054012
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Entity Type | Organization
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Legal Business Name | MEDILABS LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 1302 4TH AVE STE 1
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City | CONWAY
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State | SC
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Zip | 29526-5018
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Country | US
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Telephone | 843-438-8064
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Fax | 843-438-8064
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Provider Business Mailing Address
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Address Line | 217 AUGUSTA GREEN WAY
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-7163
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Country | US
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Telephone | 843-543-2444
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WAKEETA ROWE
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Credential | MBA
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Telephone | 843-438-8064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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