Source Diagnostics of South Carolina, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC

Practice address

2701 S Ocean Blvd
Unit 1831
North Myrtle Beach, SC 29582-4641

Phone

(440) 645-7822

NPI assigned

May 24, 2012

Last updated

May 24, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kathleen A Barry

Title

Coo

Phone

(440) 645-7822

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1245590140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5275 NAIMAN PKWY",
            "address_2": "SUITE E",
            "city": "SOLON",
            "state": "OH",
            "postal_code": "441391029",
            "telephone_number": "440-645-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S OCEAN BLVD",
            "address_2": "UNIT 1831",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295824641",
            "telephone_number": "440-645-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "440-645-7822"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Sobotka, FNP-C
• Social Pulse Home Care Agency
• John Soileau, DVM
• Monica Jean Sojka, LISW-CP
• Sound Solutions
• George Peter Sourlis, DMD
• South Carolina CVS Pharmacy LLC (CVS Pharmacy #07396)
• South Carolina CVS Pharmacy LLC (CVS Pharmacy#07366)
• Christina D Spearman, FNP-BC
• Speech and Language Therapy Services, LLC

• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in North Myrtle Beach, SC
• Providers in North Myrtle Beach, SC by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.