Provider Demographics
NPI:1396814190
Name:CLAY COUNTY SCHOOL SYSTEM
Entity Type:Organization
Organization Name:CLAY COUNTY SCHOOL SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-273-3217
Mailing Address - Street 1:146 ALLISON RD
Mailing Address - Street 2:
Mailing Address - City:CORDELE
Mailing Address - State:GA
Mailing Address - Zip Code:31015-8022
Mailing Address - Country:US
Mailing Address - Phone:229-273-3217
Mailing Address - Fax:229-273-0704
Practice Address - Street 1:111 COMMERCE ST E
Practice Address - Street 2:
Practice Address - City:FORT GAINES
Practice Address - State:GA
Practice Address - Zip Code:39851-3619
Practice Address - Country:US
Practice Address - Phone:229-273-3217
Practice Address - Fax:229-273-0704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
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
GA00775266AOtherPROVIDER NUMBER