Organization
CAPE FEAR IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA L JESSUP (MEMBER MANAGER)
(910) 880-9380
Entity
Organization
Contact information
Practice address
6361 OCEAN HWY E, WINNABOW, NC 28479-5758
(910) 755-3415
Mailing address
470 DEEP WATER DR SE, BOLIVIA, NC 28422-8686
(910) 755-3415
(910) 755-3415
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
—
—
207UN0902X
Nuclear Imaging & Therapy Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
246Z00000X
Other Specialist/Technologist
—
—
247100000X
Radiologic Technologist
—
—
2471N0900X
Nuclear Medicine Technology Radiologic Technologist
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
293D00000X
Physiological Laboratory
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
NC
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
—
—
Other
Enumeration date
11/02/2013
Last updated
03/17/2018
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