Provider Demographics
NPI:1144928383
Name:HEALTHBRIDGE DIAGNOSTICS LLC
Entity type:Organization
Organization Name:HEALTHBRIDGE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JEFFERSON
Authorized Official - Last Name:BOITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-220-2781
Mailing Address - Street 1:838 POWDERSVILLE RD STE F
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-3703
Mailing Address - Country:US
Mailing Address - Phone:864-442-3095
Mailing Address - Fax:864-880-2783
Practice Address - Street 1:838 POWDERSVILLE RD STE F
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-3703
Practice Address - Country:US
Practice Address - Phone:864-442-3095
Practice Address - Fax:864-880-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies