Provider Demographics
NPI:1275688855
Name:HERTFORD COUNTY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:HERTFORD COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:BASHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-358-1761
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:NC
Mailing Address - Zip Code:27986-0158
Mailing Address - Country:US
Mailing Address - Phone:252-358-1761
Mailing Address - Fax:252-358-4745
Practice Address - Street 1:701 N. MARTIN STREET
Practice Address - Street 2:
Practice Address - City:WINTON
Practice Address - State:NC
Practice Address - Zip Code:27986
Practice Address - Country:US
Practice Address - Phone:252-358-1761
Practice Address - Fax:252-358-4745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8600092Medicaid