Healthcare Provider Details

I. General information

NPI: 1568060689
Provider Name (Legal Business Name): LEXINGTON HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E MEDICAL LN STE 300
WEST COLUMBIA SC
29169-4848
US

IV. Provider business mailing address

PO BOX 6069
WEST COLUMBIA SC
29171-6069
US

V. Phone/Fax

Practice location:
  • Phone: 803-739-3570
  • Fax: 803-739-3575
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY BRILLHART
Title or Position: SENIOR VP/CFO
Credential:
Phone: 803-791-2967