Provider Demographics
NPI:1679795819
Name:UNION PUBLIC SCHOOL DISTRICT
Entity Type:Organization
Organization Name:UNION PUBLIC SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-774-9579
Mailing Address - Street 1:417 S DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MS
Mailing Address - Zip Code:39365-2621
Mailing Address - Country:US
Mailing Address - Phone:601-774-9579
Mailing Address - Fax:601-774-0600
Practice Address - Street 1:101 FOREST ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-2601
Practice Address - Country:US
Practice Address - Phone:601-774-8250
Practice Address - Fax:601-774-8187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
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
MS05329769Medicaid