Basic Information
| Provider Information | |||||||||
| NPI: | 1093703381 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LEXHEALTH, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | PIEDMONT HOME CARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 100 E 9TH AVE | ||||||||
| Address2: | P. O. BOX 1624 | ||||||||
| City: | LEXINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272923100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362488212 | ||||||||
| FaxNumber: | 3362486576 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 E 9TH AVE | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272923100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3362488212 | ||||||||
| FaxNumber: | 3362486576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ALLMER | ||||||||
| AuthorizedOfficialFirstName: | ANDREA | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | INTERIM DIRECTOR/CFO | ||||||||
| AuthorizedOfficialTelephone: | 3362488212 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | HC0521 | NC | N | Agencies | Home Health | 251E00000X | HC2396 | NC | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 14276 | 01 | NC | PARTNERS INSURANCE | OTHER | 3407185 | 05 | NC | MEDICAID | 0071F | 01 | NC | BCBS PROVIDER # | OTHER |