Provider Demographics
NPI:1760529184
Name:BARDSTOWN INDEPENDENT SCHOOLS
Entity Type:Organization
Organization Name:BARDSTOWN INDEPENDENT SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLSCLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-331-8800
Mailing Address - Street 1:308 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-1406
Mailing Address - Country:US
Mailing Address - Phone:502-331-8800
Mailing Address - Fax:502-331-8830
Practice Address - Street 1:308 N 5TH ST
Practice Address - Street 2:
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-1406
Practice Address - Country:US
Practice Address - Phone:502-331-8800
Practice Address - Fax:502-331-8830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21000179Medicaid