Healthcare Provider Details

I. General information

NPI: 1649203423
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 COLUMBIA AVENUE
CHAPIN SC
29036
US

IV. Provider business mailing address

PO BOX 896239
CHARLOTTE NC
28289-6239
US

V. Phone/Fax

Practice location:
  • Phone: 803-932-0655
  • Fax: 803-932-0571
Mailing address:
  • Phone: 803-932-0655
  • Fax: 803-932-0571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELINDA P KRUZNER
Title or Position: CFO & SR. VP
Credential:
Phone: 903-791-2000