Waccamaw Ultrasound & Diagnostics, Inc.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

WACCAMAW ULTRASOUND & DIAGNOSTICS, INC.

Practice address

619 Jefferson St
Whiteville, NC 28472-3707

Phone

(910) 642-9085

NPI assigned

Dec 15, 2005

Last updated

Aug 22, 2020By 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

Mr. Anthony John Grigsby

Title

President

Phone

(910) 642-9085

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457336174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 E WHITE OAK ST",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284502128",
            "telephone_number": "910-642-9085",
            "fax_number": "910-642-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 JEFFERSON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284723707",
            "telephone_number": "910-642-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW ULTRASOUND & DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRIGSBY",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-642-9085",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890129L",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Veronica Crawley, Ma, LPC, NCC, PLLC
• W.Sidney Gibson, DDS, PA
• Waccamaw Associates (Waccamaw Pyschological Associates)
• Waccamaw Compounding Pharmacy
• Waccamaw Primary Care Inc
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-1268)
• Wal-Mart Stores East, LP (Vision Center 30-1268)
• Richard M Waldman, MD
• Walgreen Co (Walgreens #09898)
• Walgreen Co (Rite Aid)

• Physiological Laboratory in Whiteville, NC
• Providers in Whiteville, NC by specialty
• Physiological Laboratory in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.