1093737561 NPI number — CAMPBELL COUNTY SCHOOLS

Table of content: (NPI 1093737561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093737561 NPI number — CAMPBELL COUNTY SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAMPBELL COUNTY 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:
1093737561
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
684 VILLAGE HIGHWAY
Provider Second Line Business Mailing Address:
P.O. BOX 99
Provider Business Mailing Address City Name:
RUSTBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24592
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-332-3458
Provider Business Mailing Address Fax Number:
434-528-1655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
684 VILLAGE HWY.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUSTBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-332-3458
Provider Business Practice Location Address Fax Number:
434-528-1655
Provider Enumeration Date:
07/24/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PLETKE
Authorized Official First Name:
CINDEE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR, PUPIL PERSONNEL SERVICES
Authorized Official Telephone Number:
434-332-8231

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)