Provider Demographics
NPI:1760511620
Name:LAMAR COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LAMAR COUNTY SCHOOL DISTRICT
Other - Org Name:BAXTERVILLE SCHOOL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT OF EDUCATION LAMAR C
Authorized Official - Prefix:MR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-794-1030
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:PURVIS
Mailing Address - State:MS
Mailing Address - Zip Code:39475
Mailing Address - Country:US
Mailing Address - Phone:601-794-1030
Mailing Address - Fax:601-794-1012
Practice Address - Street 1:5531 HWY 13
Practice Address - Street 2:BAXTERVILLE SCHOOL
Practice Address - City:LUMBERTON
Practice Address - State:MS
Practice Address - Zip Code:39455
Practice Address - Country:US
Practice Address - Phone:601-796-4483
Practice Address - Fax:601-796-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR729744163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS9016072Medicaid