1669869160 NPI number — PRINCE GEORGE'S COUNTY PUBLIC SCHOOLS

Table of content: DORA DAVIS DAVIS RN (NPI 1225524432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669869160 NPI number — PRINCE GEORGE'S COUNTY PUBLIC SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRINCE GEORGE'S COUNTY PUBLIC SCHOOLS
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:
Provider Other Organization Name Type Code:
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:
1669869160
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14201 SCHOOL LN
Provider Second Line Business Mailing Address:
TEMP 07-525
Provider Business Mailing Address City Name:
UPPER MARLBORO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20772-2866
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-952-6349
Provider Business Mailing Address Fax Number:
301-780-5925

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14201 SCHOOL LN
Provider Second Line Business Practice Location Address:
TEMP 07-525
Provider Business Practice Location Address City Name:
UPPER MARLBORO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20772-2866
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-952-6349
Provider Business Practice Location Address Fax Number:
301-780-5925
Provider Enumeration Date:
04/22/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MAXWELL
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
301-952-6349

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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