| NPI |
1699793182 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
| Entity Type Code |
2 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
| Employer Identification Number EIN |
|
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified. |
| Provider Organization Name Legal Business Name |
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC. |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
| Provider Other Organization Name |
LEXINGTON MEDICAL CENTER LEXINGTON |
Other name by which the organization provider is or has been known. |
| Provider Other Organization Name Type Code |
3 |
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional
name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other. |
| Provider First Line Business Practice Location Address |
811 WEST MAIN STREET |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
| Provider Business Practice Location Address City Name |
LEXINGTON |
The city name in the location address of the provider being identified. |
| Provider Business Practice Location Address State Name |
SC |
The State code in the location of the provider
being identified. |
| Provider Business Practice Location Address Postal Code |
29072 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Provider Business Practice Location Address Country Code If outside U S |
US |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
| Provider Business Practice Location Address Telephone Number |
8033586100 |
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual
human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO). |
| Provider Business Practice Location Address Fax Number |
8033586167 |
The last name of the provider. If the provider is an individual, this is the legal name. |
| Provider Enumeration Date |
7/17/2006 |
The first name of the provider, if the provider
is an individual. |
| Last Update Date |
6/1/2010 |
The name prefix or salutation of the provider
if the provider is an individual; for example, Mr., Mrs., or Corporal. |
| Authorized Official Last Name |
KRUZNER |
The abbreviations for professional degrees or credentials used or held by the provider,
if the provider is an individual. Examples
are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations
will not be verified by NPS. |
| Authorized Official First Name |
MELINDA |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
| Authorized Official Middle Name |
P |
The city name in the location address of the provider being identified. |
| Authorized Official Title or Position |
CFO & SR. VP |
The State code in the location of the provider
being identified. |
| Authorized Official Telephone Number |
8039394577 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
| Healthcare Provider Taxonomy Code 1 |
291U00000X |
The country code in the location address of the provider being identified. |
| Healthcare Provider Primary Taxonomy Switch 1 |
Y |
The telephone number associated with the location address of the provider being identified. |
| Other Provider Identifier 1 |
=========034 |
The fax number associated with the location
address of the provider being identified. |
| Other Provider Identifier Type Code 1 |
01 |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
| Other Provider Identifier State 1 |
SC |
|
| Other Provider Identifier Issuer 1 |
TRICARE |
|
| Other Provider Identifier 2 |
L00135 |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
| Other Provider Identifier Type Code 2 |
05 |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
| Other Provider Identifier State 2 |
SC |
|
| Other Provider Identifier 3 |
=========047 |
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form. |
| Other Provider Identifier Type Code 3 |
01 |
Code indicating the type of identifier currently
or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form. |
| Other Provider Identifier State 3 |
SC |
|
| Other Provider Identifier Issuer 3 |
BCBS LMC LEX LAB |
|
| Is Organization Subpart |
Y |
|
| Parent Organization LBN |
LEXINGTON COUNTY HEALTH SERVICES DISTRICT, INC. |
|
| Parent Organization TIN |
|
|