Provider Demographics
NPI:1356007629
Name:MEDICINE CABINET LLC
Entity Type:Organization
Organization Name:MEDICINE CABINET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARTOE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-393-3386
Mailing Address - Street 1:PO BOX 600
Mailing Address - Street 2:
Mailing Address - City:KERMIT
Mailing Address - State:WV
Mailing Address - Zip Code:25674-0600
Mailing Address - Country:US
Mailing Address - Phone:304-393-3386
Mailing Address - Fax:304-393-3387
Practice Address - Street 1:50 LINCOLN STREET
Practice Address - Street 2:
Practice Address - City:KERMIT
Practice Address - State:WV
Practice Address - Zip Code:25674-2567
Practice Address - Country:US
Practice Address - Phone:304-393-3386
Practice Address - Fax:304-393-3387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty