MEDICARE: POPE DIAGNOSTICS, LLC

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
1	2471V0105X	Vascular Sonography Radiologic Technologist

General Provider Information

NPI Number	:	1841531928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POPE DIAGNOSTICS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 292158
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29229-0036
Country	:	US
Telephone Number	:	803-807-9533
Fax Number	:	877-903-1383

Provider Business Practice Location Address
First Line	:	101 RICE BENT WAY
Second Line	:	SUITE 12
City	:	COLUMBIA
State	:	SC
Zip	:	29229-6849
Country	:	US
Telephone Number	:	803-807-9533
Fax Number	:	877-903-1383

Authorized Official
Title or Position	:	OWNER
Name	:	MR. DWAYNE POPE
Credential	:	RVT
Telephone Number	:	803-807-9533

Provider Enumeration Date	:	03/14/2013
Last Update Date	:	03/14/2013

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Directions to “POPE DIAGNOSTICS, LLC ” Practice Location

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