1043388937 NPI number — HARALSON COUNTY BOARD OF EDUCATION

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 1043388937 NPI number — HARALSON COUNTY BOARD OF EDUCATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARALSON COUNTY 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:
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:
1043388937
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
06/03/2008
NPI Reactivation Date:
02/19/2010

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 VAN WERT ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUCHANAN
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30113-4879
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-646-3882
Provider Business Mailing Address Fax Number:
770-646-8628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 VAN WERT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUCHANAN
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30113-4879
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-646-3882
Provider Business Practice Location Address Fax Number:
770-646-8628
Provider Enumeration Date:
12/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROBINSON
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION COORDINATOR
Authorized Official Telephone Number:
770-646-3882

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  235Z00000N , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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