Provider Demographics
NPI:1205854163
Name:LEXINGTON COUNTY HEALTH SERVICE DISTRICT INC.
Entity Type:Organization
Organization Name:LEXINGTON COUNTY HEALTH SERVICE DISTRICT INC.
Other - Org Name:LEXINGTON SURGICAL ASSOCIATES-WEST COLUMBIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDETIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-936-7679
Mailing Address - Street 1:2720 SUNSET BLVD
Mailing Address - Street 2:ATTN: MANAGED CARE DEPARTMENT
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-4810
Mailing Address - Country:US
Mailing Address - Phone:803-791-2000
Mailing Address - Fax:
Practice Address - Street 1:2728 SUNSET BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4838
Practice Address - Country:US
Practice Address - Phone:803-939-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7831Medicare ID - Type Unspecified