Provider Demographics
NPI:1083769251
Name:BELLEVUE BOARD OF EDUCATION
Entity Type:Organization
Organization Name:BELLEVUE BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:C
Authorized Official - Last Name:WORMALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-261-7227
Mailing Address - Street 1:219 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1401
Mailing Address - Country:US
Mailing Address - Phone:859-261-7227
Mailing Address - Fax:859-261-0477
Practice Address - Street 1:219 CENTER ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:KY
Practice Address - Zip Code:41073-1401
Practice Address - Country:US
Practice Address - Phone:859-261-7227
Practice Address - Fax:859-261-0477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
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
KY21019047Medicare ID - Type Unspecified