Healthcare Provider Details

I. General information

NPI: 1326066283
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 10/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2728 SUNSET BLVD SUITE 310
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

2728 SUNSET BLVD SUITE 310
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-8080
  • Fax: 803-936-8079
Mailing address:
  • Phone: 803-936-8080
  • Fax: 803-936-8079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA P KRUZNER
Title or Position: SR. VP &CFO
Credential:
Phone: 803-791-2000