CAROLINA FOREST IMAGING CENTER LLC NPI 1063603587

NPI Information

NPI: 1063603587
Provider Name: CAROLINA FOREST IMAGING CENTER LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
199 VILLAGE CENTER BLVD
SUITE 110
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 236-7878
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CAROLINA FOREST IMAGING CENTER LLC is a radiology clinic center in Myrtle Beach, SC. CAROLINA FOREST IMAGING CENTER LLC NPI is 1063603587. The provider is registered as an organization entity type.

The provider's business location address is:

199 VILLAGE CENTER BLVD
SUITE 110
MYRTLE BEACH, SC
ZIP 29579
Phone: (843) 236-7878
Fax: (843) 236-6406

The provider's authorized official is Lavelle R Hardin .
The authorized official title is Credentialing Coordinator and has the following contact phone number (615) 344-8203.

The enumeration date for this NPI number is 8/8/2007 and was last updated on 11/30/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM1200X	Clinic/Center	Magnetic Resonance Imaging (MRI)	No
2	261QR0206X	Clinic/Center	Radiology, Mammography	No
3	261QR0200X	Clinic/Center	Radiology	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GP4758	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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