Longs Drugs of Lexington SC Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

108052 Issued in AK

Legal business name

LONGS DRUGS OF LEXINGTON SC INC

Doing business as

Avita Pharmacy 1051

Practice address

1216 W Main St
Lexington, SC 29072-2453

Phone

(803) 358-3030

Fax

(803) 358-3034

NPI assigned

Aug 8, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Ellis

Title

Corporate Counsel

Phone

(803) 254-5884

Specialties & licenses 15

Addresses

Other identifiers 2

Other names 1

• Avita Pharmacy 1051 Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Longs Drugs of Lexington SC Inc

  • Community/Retail Pharmacy
  • North Charleston, SC
  • NPI 1235812587

  1355563206

  Same PAC ID

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Todd Burnett, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1962945188
  NPD (past)
• Alex Cooper, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1740799766
  NPD (past)
• Amelia Brooke Douglass, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1639856891
  NPD (past)
• Matthew Martin, PHARM.D.

  • Pharmacist
  • Lexington, SC
  • NPI 1144625989
  NPD (past)
• Amanda S Shumpert, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1205068848
  NPD (past)
• Casey M Sluder, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1598307050
  NPD (past)
• Anna Todd, PHARMD

  • Pharmacist
  • Lexington, SC
  • NPI 1932749819
  NPD (past)
• Brenna Veres

  • Pharmacist
  • Lexington, SC
  • NPI 1689926560
  NPD (past)
• Joel Duane Yates II, RPH., B.S.

  • Pharmacist
  • Lexington, SC
  • NPI 1346475456
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1174779219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602683",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602683",
            "telephone_number": "803-358-3030",
            "fax_number": "803-358-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 W MAIN ST",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722453",
            "telephone_number": "803-358-3030",
            "fax_number": "803-358-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGS DRUGS OF LEXINGTON SC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CORPORATE COUNSEL",
        "authorized_official_telephone_number": "803-254-5884"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DC",
            "license": "NRX0000789",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "320011982",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "GA",
            "license": "PHNR000221",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KY",
            "license": "SC1980",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "HI",
            "license": "1240",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH29285",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "ID",
            "license": "41111MS",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IN",
            "license": "64002113A",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IA",
            "license": "4658",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CT",
            "license": "PCN.0003017",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CO",
            "license": "OSP.0006745",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AK",
            "license": "108052",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "DE",
            "license": "11597",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.007436-NR",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006749",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2116693",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174779219",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita Pharmacy 1051",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melanie Lombardi, PHARMD, RPH
• Stephanie Lomeli Garcia
• Londry & Modlin IX DDS LLC
• Carol Loney
• Emily Marie Long, LPC
• Longs Drugs of Lexington SC Inc (Long's Drugs of Lexington)
• Amy Loper, APRN
• Alexa Lopez, CD(DONA)
• Jose C. Lopez Jr., MSW
• Alessandra Lorah, OTR/L

• Community/Retail Pharmacy in Lexington, SC
• Providers in Lexington, SC by specialty
• Community/Retail Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.