Organization
SOURCE DIAGNOSTICS OF SOUTH CAROLINA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A BARRY (COO)
(440) 645-7822
Entity
Organization
Contact information
Practice address
2701 S OCEAN BLVD, UNIT 1831, NORTH MYRTLE BEACH, SC 29582-4641
(440) 645-7822
Mailing address
5275 NAIMAN PKWY, SUITE E, SOLON, OH 44139-1029
(440) 645-7822
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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