NPIMap

Organization Active NPI

Pathology Associates of South Carolina

  • Physiological Laboratory
  • Rock Hill, SC
National Provider Identifier
1053507780
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
PATHOLOGY ASSOCIATES OF SOUTH CAROLINA
Practice address
222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone
(803) 328-0888
Fax
(803) 329-5105
NPI assigned
Sep 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James L Maynard, M.D.
Title
President
Phone
(803) 328-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X SC Primary

Addresses

Primary practice location

222 S Herlong Ave
Rock Hill, SC 29732-1158

Mailing address

222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone (803) 328-0888

Other identifiers 1

IdentifierTypeStateIssuer
PA5529MedicaidSC

National Provider Directory

National Provider Directory
Tax ID family
Pathology Associates of South Carolina2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189987200000",
    "number": "1053507780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-328-0888",
            "fax_number": "803-329-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S HERLONG AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321158",
            "telephone_number": "803-328-0888",
            "fax_number": "803-329-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHOLOGY ASSOCIATES OF SOUTH CAROLINA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2007-09-17",
        "status": "A",
        "authorized_official_last_name": "MAYNARD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "803-328-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PA5529",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.