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NPI Code Detail

MEDICARE: LEXINGTON COUNTY HEALTH SERVICE DISTRICT INC.

MEDICARE: LEXINGTON COUNTY HEALTH SERVICE DISTRICT INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician

General Provider Information

NPI Number : 1205854163
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEXINGTON COUNTY HEALTH SERVICE DISTRICT INC.
Provider Business Mailing Address
First Line : 2720 SUNSET BLVD
Second Line : ATTN: MANAGED CARE DEPARTMENT
City : WEST COLUMBIA
State : SC
Zip : 29169-4810
Country : US
Telephone Number : 803-791-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2728 SUNSET BLVD STE 104
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4838
Country : US
Telephone Number : 803-939-2723
Fax Number :
Authorized Official
Title or Position : CREDETIALING SPECIALIST
Name : KAREN HENDERSON
Credential :
Telephone Number : 803-936-7679
Provider Enumeration Date : 07/18/2006
Last Update Date : 08/22/2020

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