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General NPI Number Information
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NPI Number | 1962126474
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Entity Type | Organization
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Legal Business Name | MEDICINE CABINET CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 319 MERCY ST STE A
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City | LAKE CITY
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State | SC
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Zip | 29560-2331
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Country | US
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Telephone | 843-374-2858
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Fax | 843-374-9914
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Provider Business Mailing Address
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Address Line | 319 MERCY ST STE A
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City | LAKE CITY
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State | SC
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Zip | 29560-2331
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Country | US
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Telephone | 843-374-2825
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Fax | 843-374-9914
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Authorized Official
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Title or Position | OWNER, AUTHORIZED OFFICIAL
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Name | LESLIE ERIN STELLING
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Credential | PHARMD, MBA
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Telephone | 843-374-2825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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