Provider Demographics
NPI:1275639742
Name:NEW LEXINGTON CLINIC, PSC
Entity Type:Organization
Organization Name:NEW LEXINGTON CLINIC, PSC
Other - Org Name:FIRST CHOICE WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-258-4101
Mailing Address - Street 1:PO BOX 11790
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40578-1790
Mailing Address - Country:US
Mailing Address - Phone:859-258-6000
Mailing Address - Fax:859-258-6123
Practice Address - Street 1:3061 FIELDSTONE WAY
Practice Address - Street 2:SUITE 700
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1718
Practice Address - Country:US
Practice Address - Phone:859-296-9900
Practice Address - Fax:859-296-9603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW LEXINGTON CLINIC, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-15
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65923740Medicaid
KY6836Medicare ID - Type Unspecified
KY65923740Medicaid