MEDICARE: LEXINGTON SCHOOL DISTRICT 2

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1609826395
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEXINGTON SCHOOL DISTRICT 2

Provider Business Mailing Address
First Line	:	715 9TH ST
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-7169
Country	:	US
Telephone Number	:	803-796-4708
Fax Number	:	803-739-4066

Provider Business Practice Location Address
First Line	:	715 9TH ST
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-7169
Country	:	US
Telephone Number	:	803-796-4708
Fax Number	:	803-739-4066

Authorized Official
Title or Position	:	SUPERINTENDENT
Name	:	MR. BARRY BOLEN
Credential	:
Telephone Number	:	803-796-4708

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	08/22/2020

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Directions to “LEXINGTON SCHOOL DISTRICT 2 ” Practice Location

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