Healthcare Provider Details

I. General information

NPI: 1306887203
Provider Name (Legal Business Name): LEXINGTON REHABILITATION AND NURSING CENTER-LEXINGTON SC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2416 SUNSET BLVD
WEST COLUMBIA SC
29169-4718
US

IV. Provider business mailing address

333 N SUMMIT ST ATTN BARRY LAZARUS
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 803-796-8024
  • Fax: 803-796-5485
Mailing address:
  • Phone: 419-252-5541
  • Fax: 419-252-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNCF-474
License Number StateSC

VIII. Authorized Official

Name: MR. BARRY A LAZARUS
Title or Position: VICE PRESIDENT - REIMBURSEMENTS
Credential:
Phone: 419-252-5541