Organization
SHORELINE IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY NICHOLE SCHUMAL RT(S)(VS) (CO-OWNER)
(843) 251-5983
Entity
Organization
Contact information
Practice address
910 GYPSY LN, MC CLELLANVILLE, SC 29458-9733
(843) 251-5983
Mailing address
PO BOX 16103, MYRTLE BEACH, SC 29587-6103
(843) 251-5983
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
40231
SC
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
447384
SC
Other
Enumeration date
05/20/2013
Last updated
07/31/2014
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