Provider Demographics
NPI:1043381759
Name:CHESAPEAKE CITY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:CHESAPEAKE CITY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:W.
Authorized Official - Middle Name:RANDOPH
Authorized Official - Last Name:NICHOLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-547-0153
Mailing Address - Street 1:PO BOX 16496
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23328-6496
Mailing Address - Country:US
Mailing Address - Phone:757-547-0153
Mailing Address - Fax:757-547-0929
Practice Address - Street 1:2107 E. LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324
Practice Address - Country:US
Practice Address - Phone:757-494-7600
Practice Address - Fax:757-494-7573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========Medicaid