Organization
WACCAMAW ULTRASOUND & DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY JOHN GRIGSBY (PRESIDENT)
(910) 642-9085
Entity
Organization
Contact information
Practice address
619 JEFFERSON ST, WHITEVILLE, NC 28472-3707
(910) 642-9085
Mailing address
112 E WHITE OAK ST, LAKE WACCAMAW, NC 28450-2128
(910) 642-9085
(910) 642-3082
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890129L
—
NC
Enumeration date
12/15/2005
Last updated
08/22/2020
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