Provider Demographics
NPI:1487669024
Name:LEXINGTON PHARMACAL INC
Entity Type:Organization
Organization Name:LEXINGTON PHARMACAL INC
Other - Org Name:BIERER'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/PIC
Authorized Official - Prefix:
Authorized Official - First Name:MAMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GURUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-463-3119
Mailing Address - Street 1:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-0775
Mailing Address - Country:US
Mailing Address - Phone:540-463-3119
Mailing Address - Fax:540-463-3111
Practice Address - Street 1:146 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-2356
Practice Address - Country:US
Practice Address - Phone:540-463-3119
Practice Address - Fax:540-463-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
VA02010000413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4806797OtherNCPDP PROVIDER IDENTIFICATION NUMBER
VA009106626Medicaid
VA8500118Medicaid
0638900001Medicare NSC