Healthcare Provider Details

I. General information

NPI: 1003266123
Provider Name (Legal Business Name): MATTHEW CHRISTOPHER LESNIAK RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 BLACK WALNUT DR
LEXINGTON SC
29072-6765
US

IV. Provider business mailing address

124 BLACK WALNUT DR
LEXINGTON SC
29072-6765
US

V. Phone/Fax

Practice location:
  • Phone: 803-667-8156
  • Fax:
Mailing address:
  • Phone: 803-667-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number12909
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: