Healthcare Provider Details

I. General information

NPI: 1336557545
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3799 12TH STREET EXTENSION STE 105
CAYCE SC
29033
US

IV. Provider business mailing address

470 HULON LANE ATTN: VP REVENUE CYCLE
WEST COLUMBIA SC
29169-4841
US

V. Phone/Fax

Practice location:
  • Phone: 803-926-6820
  • Fax: 803-926-6821
Mailing address:
  • Phone: 803-791-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA SARVIS
Title or Position: EXECUTIVE VP
Credential:
Phone: 803-791-2000