Medicine Cabinet of Lake City

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

14915 Issued in SC

Legal business name

MEDICINE CABINET OF LAKE CITY

Practice address

319 Mercy St
Lake City, SC 29560-2331

Phone

(843) 374-2825

Fax

(843) 374-9914

NPI assigned

Nov 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terry Blackmon, BS PHARMACYNPI 1538238951

Title

President

Phone

(843) 374-2825

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• THE MEDICINE CABINET Doing business as

Medicare fee-for-service enrollment

Enrolled in SC3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Terry Alan Blackmon, RPH

  • Pharmacist
  • Lake City, SC
  • NPI 1538238951
  NPD Authorized official
• Leslie Erin Blackmon Stelling, PHARM D

  • Pharmacist
  • Lake City, SC
  • NPI 1891093845
  NPD
• Joseph Dan Bushardt Jr., RPH

  • Pharmacist
  • Lake City, SC
  • NPI 1134298391
  NPD (past)
• Kirby Rebekah Jeffords

  • Pharmacy Technician
  • Lake City, SC
  • NPI 1568227999
  NPD (past)
• Lauren Bingham Powell

  • Pharmacist
  • Lake City, SC
  • NPI 1336827880
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417478400000",
    "number": "1306916481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602331",
            "telephone_number": "843-374-2825",
            "fax_number": "843-374-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 MERCY ST",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602331",
            "telephone_number": "843-374-2825",
            "fax_number": "843-374-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE CABINET OF LAKE CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-12-02",
        "status": "A",
        "authorized_official_last_name": "BLACKMON",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-374-2825",
        "authorized_official_credential": "BS PHARMACY"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "SC",
            "license": "14915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2089116",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "714915",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE MEDICINE CABINET",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medical Consultants of Lake City LLC
• Medical University Hospital Authority
• Medical University Hospital Authority
• Medical University Hospital Authority
• Medicine Cabinet Clinical Services LLC
• Medtran Express
• Mid-Carolina Hospital Group, LLC
• Eliza M Miles, LPN
• Albert D Mims, M.D.
• Mindful Behavioral Inc

• Community/Retail Pharmacy in Lake City, SC
• Providers in Lake City, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.