Provider Demographics
NPI:1710215363
Name:PRICHARD ELEMENTARY SCHOOL HEALTH CENTER
Entity Type:Organization
Organization Name:PRICHARD ELEMENTARY SCHOOL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THORNBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-474-6685
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-0909
Mailing Address - Country:US
Mailing Address - Phone:606-474-6685
Mailing Address - Fax:606-474-0256
Practice Address - Street 1:401 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1415
Practice Address - Country:US
Practice Address - Phone:606-474-8815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-19
Last Update Date:2009-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare