Provider Demographics
NPI:1326212275
Name:ULTRASOUND IMAGING SPECIALISTS, LLC
Entity Type:Organization
Organization Name:ULTRASOUND IMAGING SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-366-1720
Mailing Address - Street 1:1420 EBENEZER RD
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-2743
Mailing Address - Country:US
Mailing Address - Phone:803-366-1720
Mailing Address - Fax:803-366-1740
Practice Address - Street 1:1420 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2743
Practice Address - Country:US
Practice Address - Phone:803-366-1720
Practice Address - Fax:803-366-1740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ348120001Medicare PIN