Organization Active NPI

Lax Group LLC

  • Community/Retail Pharmacy
  • Charlotte, NC
National Provider Identifier
1487047874
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12639 Issued in NC
Legal business name
LAX GROUP LLC
Practice address
8035 Providence Rd Ste 300
Charlotte, NC 28277-8907
Phone
(704) 909-4700
Fax
(704) 752-4197
NPI assigned
Mar 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Dr. Vipul Patel, PHARMD
Title
Owner
Phone
(704) 909-4700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 12639 NC Primary

Addresses

Primary practice location

8035 Providence Rd Ste 300
Charlotte, NC 28277-8907

Mailing address

8035 Providence Rd Ste 100
Charlotte, NC 28277-9716
Phone (704) 909-4700

Other identifiers 1

IdentifierTypeStateIssuer
2155340OtherPK

Other names 1

  • Carolina Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181114003285 NC Part B Supplier - Pharmacy 6204180045 Practice locations: Charlotte, NC
O20200724002056 NC Part B Supplier - Independent Clinical Laboratory 6204180045 Practice locations: Charlotte, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2184397Lax Group, LLC8035 Providence Road, Suite 300, Charlotte, NC 28277Certificate of waiverMay 18, 2028

National Provider Directory

National Provider Directory
Tax ID family
Carolina Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8035 Providence Rd
Ste 100
Charlotte, NC 28277
Phone (704) 316-1222

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1487047874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8035 PROVIDENCE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282779716",
            "telephone_number": "704-909-4700",
            "fax_number": "704-752-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8035 PROVIDENCE RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282778907",
            "telephone_number": "704-909-4700",
            "fax_number": "704-752-4197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAX GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VIPUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-909-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NC",
            "license": "12639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155340",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carolina Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Carolina Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.