Provider Demographics
NPI:1588684823
Name:GREENWOOD SCHOOL DISTRICT 52
Entity Type:Organization
Organization Name:GREENWOOD SCHOOL DISTRICT 52
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-543-3100
Mailing Address - Street 1:605 JOHNSTON RD
Mailing Address - Street 2:
Mailing Address - City:NINETY SIX
Mailing Address - State:SC
Mailing Address - Zip Code:29666-1417
Mailing Address - Country:US
Mailing Address - Phone:864-543-3100
Mailing Address - Fax:864-543-3704
Practice Address - Street 1:605 JOHNSTON RD
Practice Address - Street 2:
Practice Address - City:NINETY SIX
Practice Address - State:SC
Practice Address - Zip Code:29666-1417
Practice Address - Country:US
Practice Address - Phone:864-543-3100
Practice Address - Fax:864-543-3704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCW00759SC1Medicaid