Tidelands Health Market Common Llc

NPI Registration Record

Provider / Organization	NPI	Date Certified
TIDELANDS HEALTH MARKET COMMON LLC	1609437961	2019-06-26

The organization Tidelands Health Market Common Llc is registered with the National Plan and Provider Enumeration System (NPPES) and has the assigned NPI of 1609437961. Registration indicates Tidelands Health Market Common Llc is a provider of services with a specialization in Ambulatory Health Care Facilities, Clinic/Center (Clinic/Center: Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Clinic/Center Radiology, Ambulatory Health Care Facilities) (Clinic/Center, ) (Laboratories, Physiological Laboratory) (Physiological Laboratory, ) (Physiological Laboratory, Laboratories)

Other Names:

• Tidelands Health Imaging

Entity Type	Organization
Provider Organization	TIDELANDS HEALTH MARKET COMMON LLC
Other Provider Organization	TIDELANDS HEALTH IMAGING
Practice Office Address	2200 CROW LN STE 103 MYRTLE BEACH, SC US
Practice Office Telephone	8438485000
Practice Office Fax	8438485001
Mailing Address	PO BOX 421718 GEORGETOWN, SC 294424203 US
Business Telephone	8435277000
Business Fax	8436528032
Authorized Official	ELIZABETH S WARD, EVP & CFO 8435277102

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