MEDICARE: SCHOOL DISTRICT 5 OF LEXINGTON & RICHLAND COUNTIES

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
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1669547949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCHOOL DISTRICT 5 OF LEXINGTON & RICHLAND COUNTIES

Provider Business Mailing Address
First Line	:	6745 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-2127
Country	:	US
Telephone Number	:	803-476-8222
Fax Number	:	803-476-8202

Provider Business Practice Location Address
First Line	:	6745 SAINT ANDREWS RD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29212-2127
Country	:	US
Telephone Number	:	803-476-8222
Fax Number	:	803-476-8202

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL SERVICES
Name	:	MS. MARLENE METTS
Credential	:
Telephone Number	:	803-476-8222

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	06/25/2008

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