# SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245590140
- **Authorized official:** KATHLEEN A BARRY (COO)
- **Authorized official phone:** (440) 645-7822

## Contact information

- **Practice address:** 2701 S OCEAN BLVD, UNIT 1831, NORTH MYRTLE BEACH, SC 29582-4641
- **Practice address phone:** (440) 645-7822
- **Mailing address:** 5275 NAIMAN PKWY, SUITE E, SOLON, OH 44139-1029
- **Mailing address phone:** (440) 645-7822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 05/24/2012
- **Last updated:** 05/24/2012