Provider Demographics
NPI:1114134178
Name:DESOTO COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DESOTO COUNTY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:KUYKENDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-429-5271
Mailing Address - Street 1:5 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HERNANDO
Mailing Address - State:MS
Mailing Address - Zip Code:38632-2216
Mailing Address - Country:US
Mailing Address - Phone:662-429-5271
Mailing Address - Fax:662-429-4198
Practice Address - Street 1:455 RILEY STREET
Practice Address - Street 2:HERNANDO ELEMENTARY SCHOOL
Practice Address - City:HERNANDO
Practice Address - State:MS
Practice Address - Zip Code:38632
Practice Address - Country:US
Practice Address - Phone:662-429-4160
Practice Address - Fax:662-429-4114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR820729163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS05031001Medicaid