Provider Type Icon

TIDELANDS AND MEDQUEST JOINT VENTURE LLC NPI 1083275366


NPI Information

NPI: 1083275366
Provider Name: TIDELANDS AND MEDQUEST JOINT VENTURE, LLC

Doing Business As: TIDELANDS HEALTH IMAGING

Classification: Physiological Laboratory - 293D00000X
Entity Type: Organization

CLIA Number: 42D2114585

Address:
900 21ST AVE N
MYRTLE BEACH, SC
ZIP 29577
Phone: (843) 916-1700
Get Directions

TIDELANDS AND MEDQUEST JOINT VENTURE, LLC is a physiological laboratory in Myrtle Beach, SC. The provider is a laboratory that operates independently of a hospital and physician's office to furnish physiological diagnostic services (e.g. EEG's , EKG's, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. TIDELANDS AND MEDQUEST JOINT VENTURE, LLC NPI is 1083275366. The provider is registered as an organization entity type.
The provider Is Doing Business As Tidelands Health Imaging.

The provider's business location address is:

900 21ST AVE N
MYRTLE BEACH, SC
ZIP 29577-483
Phone: (843) 916-1700
Fax: (843) 916-9460

The provider's authorized official is Elizabeth S Ward .
The authorized official title is Evp & Cfo and has the following contact phone number (843) 527-7102.

The CLIA number assigned to this NPI record is 42D2114585 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/26/2019 and was last updated on 9/11/2019.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0200XClinic/CenterRadiologyNo
2293D00000XPhysiological LaboratoryYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.