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General NPI Number Information
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NPI Number | 1538449707
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Entity Type | Organization
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Legal Business Name | L&R LAX, LLC
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 12/31/2018
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Provider Practice Location Address
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Address Line | 1755 AIRPORT RD STE 100
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City | LANCASTER
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State | SC
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Zip | 29720-4800
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Country | US
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Telephone | 803-289-0000
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Fax | 803-289-0001
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Provider Business Mailing Address
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Address Line | 1755 AIRPORT RD SUITE 100
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City | LANCASTER
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State | SC
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Zip | 29720-3896
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Country | US
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Telephone | 803-289-0000
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Fax | 803-289-0001
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Authorized Official
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Title or Position | OWNER
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Name | VIPUL PATEL
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Credential | PHARMD
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Telephone | 803-289-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 13452
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License Number State | SC
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