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Organization
MEDICINE CABINET OF LAKE CITY
Active
Organization
MEDICINE CABINET OF LAKE CITY
Active
Other names
THE MEDICINE CABINET
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY BLACKMON BS PHARMACY (PRESIDENT)
(843) 374-2825
Entity
Organization
Contact information
Practice address
319 MERCY ST, LAKE CITY, SC 29560-2331
(843) 374-2825
(843) 374-9914
Mailing address
319 MERCY ST, LAKE CITY, SC 29560-2331
(843) 374-2825
(843) 374-9914
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
14915
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2089116
PK
—
05
—
714915
—
SC
Enumeration date
11/08/2006
Last updated
12/02/2014
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