Provider Demographics
NPI:1649215773
Name:MCCORMICK SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MCCORMICK SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-852-2435
Mailing Address - Street 1:821 N MINE ST
Mailing Address - Street 2:
Mailing Address - City:MC CORMICK
Mailing Address - State:SC
Mailing Address - Zip Code:29835-9271
Mailing Address - Country:US
Mailing Address - Phone:864-852-2435
Mailing Address - Fax:864-852-2435
Practice Address - Street 1:821 N MINE ST
Practice Address - Street 2:
Practice Address - City:MC CORMICK
Practice Address - State:SC
Practice Address - Zip Code:29835-9271
Practice Address - Country:US
Practice Address - Phone:864-852-2435
Practice Address - Fax:864-852-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCW00544SC1Medicaid