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Organization

LEXINGTON COUNTY HEALTH SERV

Active
Parent organization
LEXINGTON COUNTY HEALTH SERV
Other names
Lexington Weight Management Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
LEXINGTON COUNTY HEALTH SERV
Authorized official
KAREN HENDERSON (CREDENTIALING SPECIALIST)
(803) 936-7679
Entity
Organization

Contact information

Practice address
2728 SUNSET BLVD STE 303, WEST COLUMBIA, SC 29169-4815
(803) 936-7505
Mailing address
2720 SUNSET BLVD, ATTN CREDENTIALING, WEST COLUMBIA, SC 29169-4810
(803) 936-7679
(803) 791-2122

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4705
SC
Enumeration date
01/04/2007
Last updated
10/18/2007
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