Provider Demographics
NPI:1538311857
Name:LANCASTER CLINIC CORP
Entity type:Organization
Organization Name:LANCASTER CLINIC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREWER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-892-9813
Mailing Address - Street 1:901 W. MEETING ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-6219
Mailing Address - Country:US
Mailing Address - Phone:803-285-3700
Mailing Address - Fax:803-285-3715
Practice Address - Street 1:901 W. MEETING ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6219
Practice Address - Country:US
Practice Address - Phone:803-285-3700
Practice Address - Fax:803-285-3715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCASTER CLINIC CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies