Provider Demographics
NPI:1316127541
Name:LEXINGTON TWO, INC
Entity type:Organization
Organization Name:LEXINGTON TWO, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:L
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:814-946-5411
Mailing Address - Street 1:PO BOX 352
Mailing Address - Street 2:201 CHESTNUT AVENUE
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16603-0352
Mailing Address - Country:US
Mailing Address - Phone:814-946-5411
Mailing Address - Fax:814-940-8471
Practice Address - Street 1:1216 PLEASANT VALLEY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4750
Practice Address - Country:US
Practice Address - Phone:814-941-1619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-05
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0288090001Medicare NSC
PA0288090002Medicare NSC