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PALMETTO IMAGING INC NPI 1114985397


NPI Information

NPI: 1114985397
Provider Name: PALMETTO IMAGING, INC

Doing Business As: LONG BAY DIAGNOSTIC IMAGING

Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

CLIA Number: 42D1014500

Address:
900A 21ST AVE NORTH
MYRTLE BEACH, SC
ZIP 29577
Phone: (770) 300-0101
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PALMETTO IMAGING, INC is a diagnostic radiology radiology in Myrtle Beach, SC. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. PALMETTO IMAGING, INC NPI is 1114985397. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Long Bay Diagnostic Imaging.

The provider's business location address is:

900A 21ST AVE NORTH
MYRTLE BEACH, SC
ZIP 29577-483
Phone: (770) 300-0101
Fax: (770) 300-0429

The provider's authorized official is Daniel J Schaefer .
The authorized official title is Coo and has the following contact phone number (770) 300-0101.

The CLIA number assigned to this NPI record is 42D1014500 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/3/2006 and was last updated on 6/16/2008.


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
12085R0202XRadiologyDiagnostic RadiologySOUTH CAROLINAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1470000944OTHERSOUTH CAROLINARAILROAD MEDICARE
2=========001OTHERSOUTH CAROLINATRICARE
3Q323690003MEDICARE PINSOUTH CAROLINA
4SL0049MEDICAIDSOUTH CAROLINA
5=========001OTHERSOUTH CAROLINABCBS

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: 4/28/2024

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