Provider Demographics
NPI:1073686606
Name:GLYNN COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:GLYNN COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:BULL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:912-267-4100
Mailing Address - Street 1:1313 EGMONT ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-7244
Mailing Address - Country:US
Mailing Address - Phone:912-267-4100
Mailing Address - Fax:912-267-6445
Practice Address - Street 1:1313 EGMONT ST
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-7244
Practice Address - Country:US
Practice Address - Phone:912-267-4100
Practice Address - Fax:912-267-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00777422AMedicaid