1134328297 NPI number — SCHOOL BOARD OF HARDEE COUNTY

Table of content: (NPI 1134328297)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134328297 NPI number — SCHOOL BOARD OF HARDEE COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHOOL BOARD OF HARDEE COUNTY
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:
HARDEE COUNTY SCHOOL BOARD
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:
1134328297
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1678
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAUCHULA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33873-1678
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
863-773-9058
Provider Business Mailing Address Fax Number:
863-773-4673

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1009 N 6TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUCHULA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33873-2008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
863-773-9058
Provider Business Practice Location Address Fax Number:
863-773-4673
Provider Enumeration Date:
07/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HARRELSON
Authorized Official First Name:
GREG
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
863-773-9058

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 008052715 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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