Provider Demographics
NPI:1487964359
Name:POPE DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:POPE DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWYANE
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:RVS/RCS
Authorized Official - Phone:843-812-5988
Mailing Address - Street 1:101 RICE BENT WAY
Mailing Address - Street 2:UNIT 12
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-6849
Mailing Address - Country:US
Mailing Address - Phone:843-812-5988
Mailing Address - Fax:877-903-1383
Practice Address - Street 1:101 RICE BENT WAY
Practice Address - Street 2:UNIT 12
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-6849
Practice Address - Country:US
Practice Address - Phone:843-812-5988
Practice Address - Fax:877-903-1383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier