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Organization
DIRECT DIAGNOSTIC SERVICES, LLC
Active
Organization
DIRECT DIAGNOSTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA R QUEEN (MEMBER MANAGER)
(828) 396-5634
Entity
Organization
Contact information
Practice address
4 CARRIAGE LN STE 108, CHARLESTON, SC 29407-6048
(828) 396-5634
(888) 818-8707
Mailing address
125 A WAMSUTTA MILL ROAD, MORGANTON, NC 28655-5522
(828) 430-3511
(828) 430-3513
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8105053
—
NC
05
—
SL0105
—
SC
Enumeration date
11/11/2008
Last updated
05/05/2021
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