Provider Demographics
NPI:1942273719
Name:LEXMEDICAL, INC.
Entity Type:Organization
Organization Name:LEXMEDICAL, INC.
Other - Org Name:LEXINGTON 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 1:101 W MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6773
Practice Address - Country:US
Practice Address - Phone:336-243-8615
Practice Address - Fax:336-243-8624
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
NC89013NKMedicaid
NC013NKOtherBCBS GROUP NUMBER
NCCG1312OtherRAILROAD MEDICARE
NC2943805OtherAETNA HMO
NC7848388OtherAETNA PPO
NC89013NKMedicaid
NC2319478DMedicare PIN