Healthcare Provider Details
I. General information
NPI: 1528091303
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: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4080 AUGUSTA HWY
GILBERT SC
29054-8893
US
IV. Provider business mailing address
470 HULON LANE ATTN: VP REVENUE CYCLE
WEST COLUMBIA SC
29169-4841
US
V. Phone/Fax
- Phone: 803-892-1800
- Fax: 803-892-1800
- Phone: 803-791-2000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MELINDA
SARVIS
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 803-791-2000