Provider Demographics
NPI:1073546412
Name:LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Entity Type:Organization
Organization Name:LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Other - Org Name:LEXINGTON MED CTR BATESBURG LEESVILLE RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KRUZNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-791-2000
Mailing Address - Street 1:338 E COLUMBIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:BATESBURG-LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070
Mailing Address - Country:US
Mailing Address - Phone:803-604-0066
Mailing Address - Fax:803-604-9924
Practice Address - Street 1:338 E COLUMBIA AVENUE
Practice Address - Street 2:
Practice Address - City:BATESBURG-LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070
Practice Address - Country:US
Practice Address - Phone:803-604-0066
Practice Address - Fax:803-604-9924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-09
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC 533Medicaid
SC428945Medicare PIN