Healthcare Provider Details

I. General information

NPI: 1013935972
Provider Name (Legal Business Name): LEXINGTON COUNTY HEALTH SERVIES DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 11/05/2020
Certification Date: 11/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 SUNSET BLVD
WEST COLUMBIA SC
29169
US

IV. Provider business mailing address

PO BOX 896239
CHARLOTTE NC
28289-6239
US

V. Phone/Fax

Practice location:
  • Phone: 803-791-2480
  • Fax: 803-936-4102
Mailing address:
  • Phone: 803-791-2480
  • Fax: 803-936-4102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MELINDA SARVIS
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 803-791-2000