Healthcare Provider Details

I. General information

NPI: 1326545617
Provider Name (Legal Business Name): LEXINGTON DRUG STORE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 E CENTER ST
LEXINGTON NC
27292-4109
US

IV. Provider business mailing address

1107 W MARKET CENTER DR
HIGH POINT NC
27260-1642
US

V. Phone/Fax

Practice location:
  • Phone: 336-248-5623
  • Fax: 336-248-6722
Mailing address:
  • Phone: 336-438-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number05527
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RUSSELL PATTERSON
Title or Position: OWNER
Credential:
Phone: 336-817-6794