Healthcare Provider Details

I. General information

NPI: 1861677882
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 SUNSET BLVD SUITE 103
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

2728 SUNSET BLVD SUITE 103
WEST COLUMBIA SC
29169
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7430
  • Fax: 803-936-7432
Mailing address:
  • Phone: 803-936-7430
  • Fax: 803-936-7432

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