1356366314 NPI number — LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC

Table of content: (NPI 1356366314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356366314 NPI number — LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LEXINGTON MEDICAL CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356366314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 896239
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28289-6239
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-791-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2720 SUNSET BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST COLUMBIA
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29169-4810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
803-791-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SARVIS
Authorized Official First Name:
MELINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
803-791-2000

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 313118 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 305153 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 108973800 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".