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General NPI Number Information
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NPI Number | 1235812587
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Entity Type | Organization
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Legal Business Name | LONGS DRUGS OF LEXINGTON SC INC
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Dates
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Enumeration Date | 08/11/2023
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 5064 RIVERS AVE STE 201
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-6304
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Country | US
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Telephone | 864-990-0242
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Fax |
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Provider Business Mailing Address
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Address Line | 10604 COURSEY BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-4015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF LEGAL OFFICER
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Name | CARL CODY COLQUITT
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Credential |
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Telephone | 469-850-6930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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