Healthcare Provider Details
I. General information
NPI: 1174779219
Provider Name (Legal Business Name): LONGS DRUGS OF LEXINGTON SC INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/08/2008
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1216 W MAIN ST
LEXINGTON SC
29072-2453
US
IV. Provider business mailing address
PO BOX 602683
CHARLOTTE NC
28260-2683
US
V. Phone/Fax
- Phone: 803-358-3030
- Fax: 803-358-3034
- Phone: 803-358-3030
- Fax: 803-358-3034
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | Y006749 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | NRX0000789 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 320011982 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHNR000221 |
| License Number State | GA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | SC1980 |
| License Number State | KY |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 1240 |
| License Number State | HI |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PH29285 |
| License Number State | FL |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 41111MS |
| License Number State | ID |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 64002113A |
| License Number State | IN |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 4658 |
| License Number State | IA |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PCN.0003017 |
| License Number State | CT |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | OSP.0006745 |
| License Number State | CO |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 11597 |
| License Number State | DE |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | PHY.007436-NR |
| License Number State | LA |
| # 15 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 108052 |
| License Number State | AK |
VIII. Authorized Official
Name:
ASHLEY
ELLIS
Title or Position: CORPORATE COUNSEL
Credential:
Phone: 803-254-5884
