Basic Information
| Provider Information | |||||||||
| NPI: | 1356783443 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AMERIPATH SC, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 272 W COLEMAN BLVD | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433886911 | ||||||||
| FaxNumber: | 8433886917 | ||||||||
| Practice Location | |||||||||
| Address1: | 272 W COLEMAN BLVD | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294643463 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8433886911 | ||||||||
| FaxNumber: | 8433886917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2013 | ||||||||
| LastUpdateDate: | 07/18/2013 | ||||||||
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| AuthorizedOfficialLastName: | KRAMER | ||||||||
| AuthorizedOfficialFirstName: | E | ||||||||
| AuthorizedOfficialMiddleName: | MICHAEL | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 6105503003 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | 42D1015001 | SC | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.