WACCAMAW IMAGING, LLC (NPI# 1770891103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770891103 |
| Entity Type | Organization |
| Organization Name | WACCAMAW IMAGING, LLC |
| Practice Address |
3806 Peachtree Ave Wilmington NC 28403-6751 |
| Mailing Address |
112 E White Oak St Lake Waccamaw NC 28450-2128 |
| Practice Telephone | 9106461452 |
| Mailing Telephone | 9106461452 |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2010-09-20 |
| Authorized Official Name | ANTHONY GRIGSBY (MANAGER) |
| Authorized Official Telephone | 9106461452 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0208X |
Clinic/Center Specialization: Radiology, Mobile |
Ambulatory Health Care Facilities |
| Street Address |
3806 PEACHTREE AVE |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396843132 | Khaled F Jreisat | Specialist | 3806 Peachtree Ave, Suite 110, Wilmington, NC 28403-6751 | 2006-09-20 |
| 1598214587 | Lauren Victoria Hill | Counselor | 3806 Peachtree Ave, Suite 210, Wilmington, NC 28403-6751 | 2016-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 261QR0208X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology, Mobile |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144878349 | Besure LLC | Clinic/Center | 132 Western Villa Dr, Clemmons, NC 27012-8277 | 2019-08-30 |
| 1073741674 | Mobile Imaging Associates, P.C. | Clinic/Center | 3013 Raeford Rd, Suite A, Fayetteville, NC 28303-5441 | 2009-06-23 |
| 1073749099 | Mobile Imaging, Inc | Clinic/Center | 4321 Ferncreek Dr, Fayetteville, NC 28314-2543 | 2009-06-04 |
| 1114192952 | Stat Mobile Imaging, LLC | Clinic/Center | 1515 Price Grange Rd, Stoneville, NC 27048-8294 | 2008-04-23 |
| 1609911924 | Silversmiths Inc | Clinic/Center | 13 N Leslie Ln, Asheville, NC 28805-1455 | 2007-02-21 |
| 1467549121 | Ultra Imaging, LLC | Clinic/Center | 2014 Litho Pl, Fayetteville, NC 28304-2518 | 2006-10-06 |
| 1851942338 | Ultracare LLC | Clinic/Center | 4030 Wake Forest Rd Ste 349, Raleigh, NC 27609-0010 | 2019-09-25 |
| 1780239921 | Pdi Health Nc LLC | Clinic/Center | 6047 Tyvola Glen Cir, Charlotte, NC 28217-6431 | 2019-08-05 |
| 1336529197 | Twincity Medical Mobile Diagnostics | Clinic/Center | 163 Stratford Ct, Winston Salem, NC 27103 | 2015-06-05 |
| 1164737755 | Mediscan Imaging Inc | Clinic/Center | 4822 Albemarle Rd, #204, Charlotte, NC 28205-6668 | 2010-08-08 |
| Find all providers with the same taxonomy | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
Please comment or provide details below to improve the information on WACCAMAW IMAGING, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.