Provider Demographics
NPI:1346213188
Name:LEXMEDICAL, INC.
Entity Type:Organization
Organization Name:LEXMEDICAL, INC.
Other - Org Name:NORTH DAVIDSON CENTER FOR FAMILY HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-243-4653
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293-1537
Mailing Address - Country:US
Mailing Address - Phone:336-243-4656
Mailing Address - Fax:336-243-4664
Practice Address - Street 1:799 HICKORY TREE RD
Practice Address - Street 2:
Practice Address - City:WINSTON-SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-9139
Practice Address - Country:US
Practice Address - Phone:336-764-3304
Practice Address - Fax:336-764-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2706996OtherAETNA HMO
NC5523203OtherAETNA PPO
NC0281POtherBCBS GROUP NUMBER
NC890281PMedicaid
NCCG1312OtherRAILROAD MEDICARE
NC1123680001Medicare NSC
NC2706996OtherAETNA HMO