Provider Demographics
NPI:1235971136
Name:LEES INLET APOTHECARY INC.
Entity type:Organization
Organization Name:LEES INLET APOTHECARY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:843-651-7979
Mailing Address - Street 1:3579 HIGHWAY 17 BUSINESS
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576
Mailing Address - Country:US
Mailing Address - Phone:843-651-7979
Mailing Address - Fax:843-651-3319
Practice Address - Street 1:3579 HIGHWAY 17 BUSINESS
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576
Practice Address - Country:US
Practice Address - Phone:843-651-7979
Practice Address - Fax:843-651-3319
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEES INLET APOTHECARY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-11
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy