Organization
M CORP
Active
Other names
MEDICINE MART PHARMACY OF LEXINGTON SC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN M. MATHENY SR. RPH (OWNER)
(803) 957-5969
Entity
Organization
Contact information
Practice address
348B COLUMBIA AVE, LEXINGTON, SC 29072-2657
(803) 957-5969
(803) 808-1829
Mailing address
348B COLUMBIA AVE, LEXINGTON, SC 29072-2657
(803) 957-5969
(803) 808-1829
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
50-008219
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME237
—
SC
Enumeration date
02/06/2007
Last updated
08/22/2020
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