Healthcare Provider Details

I. General information

NPI: 1699062380
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MEDICAL LANE STE 220
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

PO BOX 896239
CHARLOTTE NC
28289-6239
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7476
  • Fax: 803-936-7477
Mailing address:
  • Phone: 803-936-7476
  • Fax: 803-936-7477

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