# WACCAMAW ULTRASOUND & DIAGNOSTICS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Medical Center Diagnostics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043593395
- **Authorized official:** ANTHONY GRIGSBY (PRESIDENT)
- **Authorized official phone:** (910) 642-9085

## Contact information

- **Practice address:** 112 E WHITE OAK ST, LAKE WACCAMAW, NC 28450-2128
- **Practice address phone:** (910) 642-9085
- **Mailing address:** 1515 MEDICAL CENTER DR, WILMINGTON, NC 28401-7507
- **Mailing address phone:** (910) 642-9085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2011
- **Last updated:** 09/22/2011