Provider Demographics
NPI:1457233207
Name:MAR'NAE' ESSENTIALS LLC
Entity type:Organization
Organization Name:MAR'NAE' ESSENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMATHA
Authorized Official - Middle Name:MISHELL
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-303-0458
Mailing Address - Street 1:1318 N MAIN ST # 1020
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-7308
Mailing Address - Country:US
Mailing Address - Phone:843-303-0458
Mailing Address - Fax:
Practice Address - Street 1:10765 HIGHWAY 78 E APT 312
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-8745
Practice Address - Country:US
Practice Address - Phone:843-303-0458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service