Healthcare Provider Details

I. General information

NPI: 1356374128
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3799 12TH STREET EXT STE 110
CAYCE SC
29033-3750
US

IV. Provider business mailing address

PO BOX 896239
CHARLOTTE NC
28289-6239
US

V. Phone/Fax

Practice location:
  • Phone: 803-755-3337
  • Fax: 803-955-2225
Mailing address:
  • Phone: 803-755-3337
  • Fax: 803-955-2225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

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