Provider Demographics
NPI:1821705435
Name:LOWCOUNTRY LACTATION STATION
Entity Type:Organization
Organization Name:LOWCOUNTRY LACTATION STATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:843-532-6310
Mailing Address - Street 1:2076 CHURCH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-6401
Mailing Address - Country:US
Mailing Address - Phone:843-532-6310
Mailing Address - Fax:843-998-7643
Practice Address - Street 1:2076 CHURCH CREEK DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-6401
Practice Address - Country:US
Practice Address - Phone:843-532-6310
Practice Address - Fax:843-998-7643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCL-22714OtherIBCLC ADMINISTERED BY IBCLE