NPI Code Details Logo

NPI 1841375128

NPI 1841375128 : STATE OF SOUTH CAROLINA : LEXINGTON, SC

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1841375128
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    STATE OF SOUTH CAROLINA 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/26/2006
-----------------------------------------------------
    Last Update Date     |    10/07/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1070-B SOUTH LAKE DRIVE 
-----------------------------------------------------
    City                 |    LEXINGTON
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29073
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-785-6550
-----------------------------------------------------
    Fax                  |    803-785-6556
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    400 OTARRE PKWY 
-----------------------------------------------------
    City                 |    CAYCE
-----------------------------------------------------
    State                |    SC
-----------------------------------------------------
    Zip                  |    29033-3751
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    803-898-1553
-----------------------------------------------------
    Fax                  |    803-898-2262
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR OF PATIENT BILLING
-----------------------------------------------------
    Name                 |     ZANNA  PERKINS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    803-898-1553
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    251K00000X
-----------------------------------------------------
    Taxonomy Name        |    Public Health or Welfare Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.