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Organization
INMED DIAGNOSTICS SERVICES OF SC LLC
Active
Organization
INMED DIAGNOSTICS SERVICES OF SC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN RESTIVO (CREDENTIALING MANAGER)
(352) 241-6100
Entity
Organization
Contact information
Practice address
1120 W EVANS ST, FLORENCE, SC 29501-3320
(843) 292-0082
(843) 292-0086
Mailing address
PO BOX 593869, ORLANDO, FL 32859-3869
(352) 241-6100
(352) 241-6101
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
061715
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470000122
RR MEDICARE
SC
05
—
SL0034
—
SC
Enumeration date
03/22/2007
Last updated
01/20/2022
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