Provider Demographics
NPI:1598149478
Name:LEXINGTON PHARMA INC
Entity Type:Organization
Organization Name:LEXINGTON PHARMA INC
Other - Org Name:LEXINGTON AVENUE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER / PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:KARUNAKAR
Authorized Official - Middle Name:
Authorized Official - Last Name:BHUPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-426-5555
Mailing Address - Street 1:2021 LEXINGTON AVE FRNT 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-2223
Mailing Address - Country:US
Mailing Address - Phone:212-426-5555
Mailing Address - Fax:212-426-6166
Practice Address - Street 1:2021 LEXINGTON AVE FRNT 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2223
Practice Address - Country:US
Practice Address - Phone:212-426-5555
Practice Address - Fax:212-426-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NY0338313336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154089OtherPK
NY04290704Medicaid