Organization
MIDLANDS ENDOSCOPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SUZETTE STONE (ADMINISTRATOR)
(803) 749-3770
Entity
Organization
Contact information
Practice address
1 WELLNESS BLVD, SUITE 111, IRMO, SC 29063
(803) 749-3770
(803) 749-3558
Mailing address
1 WELLNESS BLVD STE 111, MIDLANDS ENDOSCOPY CENTER, LLC, IRMO, SC 29063-2873
(803) 749-3770
(803) 749-3558
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ASC059
—
SC
Enumeration date
10/25/2006
Last updated
01/13/2020
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