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NPI Code Detail

MEDICARE: HEALTHSERV, INC

MEDICARE: HEALTHSERV, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0208XMobile Radiology Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205821634
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHSERV, INC
Provider Business Mailing Address
First Line : 3100 DICK POND RD
Second Line : SUITE D
City : MYRTLE BEACH
State : SC
Zip : 29588-7286
Country : US
Telephone Number : 843-497-1134
Fax Number : 843-294-4111
Provider Business Practice Location Address
First Line : SUITE D
Second Line : 3100 DICK POND RD
City : MYRTLE BEACH
State : SC
Zip : 29588-6835
Country : US
Telephone Number : 843-497-1134
Fax Number :
Authorized Official
Title or Position : VP OPERATION
Name : CAROL ANN LINER
Credential :
Telephone Number : 843-497-1134
Provider Enumeration Date : 09/12/2005
Last Update Date : 12/04/2007

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