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
—
—
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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