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Organization

OPEN MRI OF SIMPSONVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL J SCHAEFER (COO)
(770) 300-0101
Entity
Organization

Contact information

Practice address
413 C SE MAIN STREET, SIMPSONVILLE, SC 29681-2651
(770) 300-0101
(770) 300-0429
Mailing address
PO BOX 933548, ATLANTA, GA 31193-3548
(770) 300-0101
(770) 300-0429

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
470001386
RAILROAD MEDICARE
SC
05
SL0058
SC
Enumeration date
05/03/2006
Last updated
06/11/2008
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