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Organization

LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.

Active
Parent organization
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Other names
Lake Ridge Family Medicine
Organization subpart
Yes

Provider details

NPI number
Legal business name
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC.
Authorized official
MELINDA P KRUZNER (CFO & SR. VP)
(803) 791-2000
Entity
Organization

Contact information

Practice address
557 COLUMBIA AVENUE, SUITE D, CHAPIN, SC 29036
(803) 345-1288
(803) 345-1623
Mailing address
557 COLUMBIA AVENUE, SUITE D, CHAPIN, SC 29036
(803) 345-1288
(803) 345-1623

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4194
SC
Enumeration date
07/11/2006
Last updated
06/01/2010
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