Organization
MED MART LEX
Active
Other names
Medicine Mart of Lexington SC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GLEATON (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
3336C0003X
Community/Retail Pharmacy
Primary
16242
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2155728
PK
—
05
—
716242
—
SC
Enumeration date
11/25/2005
Last updated
12/02/2024
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