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Organization

LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.

Active
Parent organization
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Other names
Lexington Pediatric Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Authorized official
MELINDA P KRUZNER (EXECUTIVE VICE PRESIDENT)
(803) 791-2000
Entity
Organization

Contact information

Practice address
811 WEST MAIN STREET, STE 204, LEXINGTON, SC 29072
(803) 359-8855
(803) 359-1257
Mailing address
470 HULON LN, ATTN: VP REVENUE CYCLE, WEST COLUMBIA, SC 29169
(803) 359-8855
(803) 359-1257

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP0991
SC
Enumeration date
07/15/2006
Last updated
06/25/2020
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