Provider Demographics
NPI:1225138977
Name:LEXMED, INC
Entity Type:Organization
Organization Name:LEXMED, INC
Other - Org Name:LMC EXTENDED CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:STOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-359-5181
Mailing Address - Street 1:815 OLD CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9041
Mailing Address - Country:US
Mailing Address - Phone:803-359-5181
Mailing Address - Fax:803-359-2267
Practice Address - Street 1:815 OLD CHEROKEE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9041
Practice Address - Country:US
Practice Address - Phone:803-359-5181
Practice Address - Fax:803-359-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-23
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0730314000000X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC0730NFMedicaid
SC0730NFMedicaid
SC0910220001Medicare NSC
SC425321Medicare Oscar/Certification