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NPI Code Detail

MEDICARE: LONGS DRUGS OF LEXINGTON SC INC

MEDICARE: LONGS DRUGS OF LEXINGTON SC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyY006749AZ
23336C0003XCommunity/Retail PharmacyNRX0000789DC
33336C0003XCommunity/Retail Pharmacy320011982IL
43336C0003XCommunity/Retail PharmacyPHNR000221GA
53336C0003XCommunity/Retail PharmacySC1980KY
63336C0003XCommunity/Retail Pharmacy1240HI
73336C0003XCommunity/Retail PharmacyPH29285FL
83336C0003XCommunity/Retail Pharmacy41111MSID
93336C0003XCommunity/Retail Pharmacy64002113AIN
103336C0003XCommunity/Retail Pharmacy4658IA
113336C0003XCommunity/Retail PharmacyPCN.0003017CT
123336C0003XCommunity/Retail PharmacyOSP.0006745CO
133336C0003XCommunity/Retail Pharmacy11597DE
143336C0003XCommunity/Retail PharmacyPHY.007436-NRLA
153336C0003XCommunity/Retail Pharmacy108052AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12116693OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174779219
Entity Type Code : Organization
Provider Name (Legal Business Name) : LONGS DRUGS OF LEXINGTON SC INC
Provider Business Mailing Address
First Line : PO BOX 602683
Second Line :
City : CHARLOTTE
State : NC
Zip : 28260-2683
Country : US
Telephone Number : 803-358-3030
Fax Number : 803-358-3034
Provider Business Practice Location Address
First Line : 1216 W MAIN ST
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-2453
Country : US
Telephone Number : 803-358-3030
Fax Number : 803-358-3034
Authorized Official
Title or Position : CORPORATE COUNSEL
Name : ASHLEY ELLIS
Credential :
Telephone Number : 803-254-5884
Provider Enumeration Date : 08/08/2008
Last Update Date : 05/12/2021

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