Provider Demographics
NPI:1386783934
Name:EAST COAST ISOTOPES
Entity type:Organization
Organization Name:EAST COAST ISOTOPES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:THURMON
Authorized Official - Suffix:III
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:843-645-6377
Mailing Address - Street 1:149 RIVERWALK BLVD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:RIDGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29936-8190
Mailing Address - Country:US
Mailing Address - Phone:843-645-6377
Mailing Address - Fax:843-645-4133
Practice Address - Street 1:149 RIVERWALK BLVD
Practice Address - Street 2:SUITE 11
Practice Address - City:RIDGELAND
Practice Address - State:SC
Practice Address - Zip Code:29936-8190
Practice Address - Country:US
Practice Address - Phone:843-645-6377
Practice Address - Fax:843-645-4133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC500079841835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclearGroup - Single Specialty