Provider Demographics
NPI:1639134760
Name:BERKELEY COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BERKELEY COUNTY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANTLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:FINANCIAL OFFICER
Authorized Official - Phone:843-899-8658
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:MONCKS CORNER
Mailing Address - State:SC
Mailing Address - Zip Code:29461-0128
Mailing Address - Country:US
Mailing Address - Phone:843-899-8658
Mailing Address - Fax:
Practice Address - Street 1:107 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3764
Practice Address - Country:US
Practice Address - Phone:843-899-8658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
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
SCSD0801Medicaid