Provider Demographics
NPI:1932449014
Name:LEXINGTON MEDICAL CENTER
Entity Type:Organization
Organization Name:LEXINGTON MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF PHYSICAL THERAPY REHABIL
Authorized Official - Prefix:MRS
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUDE
Authorized Official - Suffix:
Authorized Official - Credentials:MPT,DPT,CCCE
Authorized Official - Phone:803-791-2564
Mailing Address - Street 1:221 JOHNNY PARRISH RD
Mailing Address - Street 2:
Mailing Address - City:WARD
Mailing Address - State:SC
Mailing Address - Zip Code:29166-9601
Mailing Address - Country:US
Mailing Address - Phone:864-980-2729
Mailing Address - Fax:
Practice Address - Street 1:123 E MEDICAL LN
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4813
Practice Address - Country:US
Practice Address - Phone:803-791-2564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2439282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital