Organization
MED MART LEX LLC
Active
Other names
Medicine Mart of Lexington
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ADAM GLEATON PHARMD (OWNER)
(803) 957-5969
Entity
Organization
Contact information
Practice address
348 COLUMBIA AVE, LEXINGTON, SC 29072-2657
(803) 957-5969
(803) 808-1829
Mailing address
348 COLUMBIA AVE, LEXINGTON, SC 29072-2657
(803) 957-5969
(803) 808-1829
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
716242
—
SC
Enumeration date
04/21/2021
Last updated
04/21/2021
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