Provider Demographics
NPI:1962126474
Name:MEDICINE CABINET CLINICAL SERVICES LLC
Entity type:Organization
Organization Name:MEDICINE CABINET CLINICAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ERIN
Authorized Official - Last Name:STELLING
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MBA
Authorized Official - Phone:843-374-2825
Mailing Address - Street 1:319 MERCY ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:SC
Mailing Address - Zip Code:29560-2331
Mailing Address - Country:US
Mailing Address - Phone:843-374-2825
Mailing Address - Fax:843-374-9914
Practice Address - Street 1:319 MERCY ST STE A
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:SC
Practice Address - Zip Code:29560-2331
Practice Address - Country:US
Practice Address - Phone:843-374-2858
Practice Address - Fax:843-374-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service