Provider Demographics
NPI:1063561884
Name:SOUND MEDICAL SYSTEMS ,LLC
Entity type:Organization
Organization Name:SOUND MEDICAL SYSTEMS ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:WELDON
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:RDCS,RVT
Authorized Official - Phone:803-957-5260
Mailing Address - Street 1:205 WILD AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8858
Mailing Address - Country:US
Mailing Address - Phone:803-957-5260
Mailing Address - Fax:803-957-4575
Practice Address - Street 1:205 WILD AZALEA CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-8858
Practice Address - Country:US
Practice Address - Phone:803-957-5260
Practice Address - Fax:803-957-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC94352246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00026063OtherMEDICARE RAILROAD
SCSL0065Medicaid