Provider Demographics
NPI:1821021254
Name:LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC
Entity Type:Organization
Organization Name:LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC
Other - Org Name:LEXINGTON MEDICAL CENTER SWANSEA RHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUZNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-791-2000
Mailing Address - Street 1:935 WEST 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:SC
Mailing Address - Zip Code:29160
Mailing Address - Country:US
Mailing Address - Phone:803-568-2000
Mailing Address - Fax:803-568-4190
Practice Address - Street 1:935 WEST 2ND STREET
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:SC
Practice Address - Zip Code:29160
Practice Address - Country:US
Practice Address - Phone:803-568-2000
Practice Address - Fax:803-568-4190
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:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRHC 507Medicaid
SCRHC 507Medicaid
SC428943Medicare Oscar/Certification