Organization
INMED DIAGNOSTICS SERVICES OF SC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN RESTIVO (CREDENTIALING MANAGER)
(352) 241-6100
Entity
Organization
Contact information
Practice address
1120 W EVANS ST, FLORENCE, SC 29501-3320
(843) 292-0082
(843) 292-0086
Mailing address
PO BOX 593869, ORLANDO, FL 32859-3869
(352) 241-6100
(352) 241-6101
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
061715
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470000122
RR MEDICARE
SC
05
—
SL0034
—
SC
Enumeration date
03/22/2007
Last updated
01/20/2022
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