Provider Demographics
NPI:1760520845
Name:TYRRELL COUNTY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:TYRRELL COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:W
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-796-1121
Mailing Address - Street 1:P.O. BOX 328
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:NC
Mailing Address - Zip Code:27925-0328
Mailing Address - Country:US
Mailing Address - Phone:252-796-1121
Mailing Address - Fax:252-796-1492
Practice Address - Street 1:210 N. ROAD ST.
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:NC
Practice Address - Zip Code:27925-0328
Practice Address - Country:US
Practice Address - Phone:252-796-1121
Practice Address - Fax:252-796-1492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
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
NC8600054Medicaid