1033377874 NPI number — BURGIN BOARD OF EDUCATION

Table of content: (NPI 1033377874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033377874 NPI number — BURGIN BOARD OF EDUCATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BURGIN BOARD OF EDUCATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BURGIN INDEPENDENT SCHOOL
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033377874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURGIN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40310-0258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-748-5282
Provider Business Mailing Address Fax Number:
859-748-4002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
440 EAST MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRODSBURG
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-734-2229
Provider Business Practice Location Address Fax Number:
859-734-2968
Provider Enumeration Date:
05/29/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ROBBINS
Authorized Official First Name:
AMY
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF SPECIAL EDUCATION
Authorized Official Telephone Number:
859-748-5282

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 611326617 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




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