Healthcare Provider Details

I. General information

NPI: 1144592387
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 N HOSPITAL DRIVE STE 330
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

PO BOX 2022
WEST COLUMBIA SC
29171-2022
US

V. Phone/Fax

Practice location:
  • Phone: 803-936-7679
  • Fax: 803-794-4317
Mailing address:
  • Phone: 803-936-7679
  • Fax: 803-794-4317

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