Basic Information
| Provider Information | |||||||||
| NPI: | 1316127541 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LEXINGTON TWO, INC | ||||||||
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| OtherOrganizationName: | HOME HEALTH RESOURCE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 352 | ||||||||
| Address2: | 201 CHESTNUT AVENUE | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166030352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149465411 | ||||||||
| FaxNumber: | 8149408471 | ||||||||
| Practice Location | |||||||||
| Address1: | 1216 PLEASANT VALLEY BLVD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ALTOONA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 166024750 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8149411619 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2007 | ||||||||
| LastUpdateDate: | 07/31/2015 | ||||||||
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| AuthorizedOfficialLastName: | FREEMAN | ||||||||
| AuthorizedOfficialFirstName: | PHILIP | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8149465411 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BP3500X | Y | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition |
No ID Information.