Provider Demographics
NPI: | 1366040602 |
---|---|
Name: | LEXINGTON HEALTH INC |
Entity Type: | Organization |
Organization Name: | LEXINGTON HEALTH INC |
Other - Org Name: | LEXINGTON ORTHOPAEDICS |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | SENIORVP/CFO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JEFFREY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BRILLHART |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 803-791-2967 |
Mailing Address - Street 1: | PO BOX 6069 |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST COLUMBIA |
Mailing Address - State: | SC |
Mailing Address - Zip Code: | 29171-6069 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 146 E HOSPITAL DR STE 140&350 |
Practice Address - Street 2: | |
Practice Address - City: | WEST COLUMBIA |
Practice Address - State: | SC |
Practice Address - Zip Code: | 29169-4800 |
Practice Address - Country: | US |
Practice Address - Phone: | 803-936-7230 |
Practice Address - Fax: | 803-936-8097 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | LEXINGTON HEALTH INC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2020-10-09 |
Last Update Date: | 2022-03-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty |