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Organization
TESTING
Active
Organization
TESTING
Active
Other names
TESTING SUPPLIER, CONTRACTOR
Organization subpart
No
Provider details
NPI number
Authorized official
CHIRVELLA LOUISE TERRY CONTRACTOR (TECHNICIAN)
(843) 229-5626
Entity
Organization
Contact information
Practice address
4100 N MAIN ST STE 104, COLUMBIA, SC 29203-5800
(843) 229-5626
(803) 814-2520
Mailing address
4100 N MAIN ST STE 104, COLUMBIA, SC 29203-5800
(843) 229-5626
(803) 814-2520
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
119254555
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119254555
CONTRACTOR
SC
Enumeration date
06/19/2018
Last updated
06/19/2018
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