Organization
LONGS DRUGS OF LEXINGTON SC INC
Active
Other names
Avita Pharmacy 1051
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY ELLIS (CORPORATE COUNSEL)
(803) 254-5884
Entity
Organization
Contact information
Practice address
1216 W MAIN ST, LEXINGTON, SC 29072-2453
(803) 358-3030
(803) 358-3034
Mailing address
PO BOX 602683, CHARLOTTE, NC 28260-2683
(803) 358-3030
(803) 358-3034
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
108052
AK
3336C0003X
Community/Retail Pharmacy
11597
DE
3336C0003X
Community/Retail Pharmacy
1240
HI
3336C0003X
Community/Retail Pharmacy
320011982
IL
3336C0003X
Community/Retail Pharmacy
41111MS
ID
3336C0003X
Community/Retail Pharmacy
4658
IA
3336C0003X
Community/Retail Pharmacy
64002113A
IN
3336C0003X
Community/Retail Pharmacy
NRX0000789
DC
3336C0003X
Community/Retail Pharmacy
OSP.0006745
CO
3336C0003X
Community/Retail Pharmacy
PCN.0003017
CT
3336C0003X
Community/Retail Pharmacy
PH29285
FL
3336C0003X
Community/Retail Pharmacy
PHNR000221
GA
3336C0003X
Community/Retail Pharmacy
PHY.007436-NR
LA
3336C0003X
Community/Retail Pharmacy
SC1980
KY
3336C0003X
Community/Retail Pharmacy
Y006749
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174779219
—
SC
01
—
2116693
PK
—
Enumeration date
08/08/2008
Last updated
05/12/2021
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