| Organization Name: | CAROLINA FOREST IMAGING CENTER LLC |
| NPI Number: | 1063603587 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAVELLE R HARDIN (CREDENTIALING COORDINATOR) |
| Mailing Address: | 199 Village Center Blvd Suite 110 Myrtle Beach |
| State: | SC US |
| Postal Code: | 29579 |
| Phone Number: | 8432367878 |
| Fax Number: | 8432366406 |
| NPI Enumeration Date: | 08/08/2007 |
| NPI Last Update Date: | 11/30/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Magnetic Resonance Imaging (MRI) |
| Taxonomy Definition: | |