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General NPI Number Information
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NPI Number | 1629132436
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Entity Type | Organization
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Legal Business Name | NEW LEXINGTON CLINIC PSC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 1221 S BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40504-2701
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Country | US
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Telephone | 859-258-4103
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Fax | 859-258-4555
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Provider Business Mailing Address
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Address Line | 1221 S BROADWAY
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City | LEXINGTON
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State | KY
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Zip | 40504-2701
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Country | US
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Telephone | 859-258-4103
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Fax | 859-258-4555
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Authorized Official
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Title or Position | SR. DIRECTOR OF OPERATIONS
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Name | LINDA HICKS
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Credential | RPH
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Telephone | 859-258-4228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | P02259
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License Number State | KY
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Taxonomy #2
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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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