Provider Demographics
NPI:1952045296
Name:LEXINGTON PHARMACY LLC
Entity Type:Organization
Organization Name:LEXINGTON PHARMACY LLC
Other - Org Name:LEXPHARM PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YILKAL
Authorized Official - Middle Name:
Authorized Official - Last Name:ENKUHAWARIAT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:240-247-7586
Mailing Address - Street 1:11 E LEXINGTON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-1732
Mailing Address - Country:US
Mailing Address - Phone:410-200-9275
Mailing Address - Fax:410-200-9274
Practice Address - Street 1:11 E LEXINGTON ST STE 100
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-1732
Practice Address - Country:US
Practice Address - Phone:410-200-9275
Practice Address - Fax:410-200-9274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-22
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy