Provider Demographics
NPI:1598364275
Name:LEX PHARMACY LLC
Entity Type:Organization
Organization Name:LEX PHARMACY LLC
Other - Org Name:LEX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMELONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-643-3132
Mailing Address - Street 1:36 SOLOMONS ISLAND RD S
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-5312
Mailing Address - Country:US
Mailing Address - Phone:410-449-2775
Mailing Address - Fax:410-517-7394
Practice Address - Street 1:36 SOLOMONS ISLAND RD S
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-5312
Practice Address - Country:US
Practice Address - Phone:410-449-2775
Practice Address - Fax:410-517-7394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy