Med Mart Lex LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

MED MART LEX LLC

Doing business as

Medicine Mart of Lexington

Practice address

348 Columbia Ave
Lexington, SC 29072-2657

Phone

(803) 957-5969

Fax

(803) 808-1829

NPI assigned

Apr 21, 2021

Organization subpart

No

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

Authorized official

Name

Michael Adam Gleaton, PHARMD

Title

Owner

Phone

(803) 957-5969

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Medicine Mart of Lexington Doing business as

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1508447418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 COLUMBIA AVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722657",
            "telephone_number": "803-957-5969",
            "fax_number": "803-808-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 COLUMBIA AVE",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290722657",
            "telephone_number": "803-957-5969",
            "fax_number": "803-808-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED MART LEX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "GLEATON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-957-5969",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716242",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicine Mart of Lexington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mark Andrew Medlin, D.M.D.

• Long Term Care Pharmacy in Lexington, SC
• Providers in Lexington, SC by specialty
• Long Term Care Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.