1538189139 NPI number — HENRY COUNTY SCHOOL BOARD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538189139 NPI number — HENRY COUNTY SCHOOL BOARD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HENRY COUNTY SCHOOL BOARD
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:
HENRY COUNTY PUBLIC SCHOOLS
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:
1538189139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
06/03/2008
NPI Reactivation Date:
07/23/2008

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8958
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLINSVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24078-8958
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
276-634-4700
Provider Business Mailing Address Fax Number:
276-638-2925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3300 KINGS MOUNTAIN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLLINSVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24078-8958
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
276-634-4700
Provider Business Practice Location Address Fax Number:
276-638-2925
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DODSON
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
D
Authorized Official Title or Position:
DIVISION SUPERINTENDENT
Authorized Official Telephone Number:
276-634-4700

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  4980158 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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