Provider Demographics
NPI:1376661553
Name:JOHNSTON COUNTY SCHOOLS
Entity Type:Organization
Organization Name:JOHNSTON COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WILMA
Authorized Official - Middle Name:BAILEY
Authorized Official - Last Name:BISESI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-934-4361
Mailing Address - Street 1:PO BOX 1336
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-1336
Mailing Address - Country:US
Mailing Address - Phone:919-934-4361
Mailing Address - Fax:919-989-9380
Practice Address - Street 1:230 N EQUITY DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-6031
Practice Address - Country:US
Practice Address - Phone:919-934-4361
Practice Address - Fax:919-989-9380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
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
NC8600055Medicaid