Provider Demographics
NPI:1790810075
Name:LEE COUNTY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:LEE COUNTY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:JONITA
Authorized Official - Middle Name:SHARMAINE
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-484-5327
Mailing Address - Street 1:521 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BISHOPVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29010-1133
Mailing Address - Country:US
Mailing Address - Phone:803-484-5327
Mailing Address - Fax:803-484-9107
Practice Address - Street 1:521 PARK ST
Practice Address - Street 2:
Practice Address - City:BISHOPVILLE
Practice Address - State:SC
Practice Address - Zip Code:29010-1133
Practice Address - Country:US
Practice Address - Phone:803-484-5327
Practice Address - Fax:803-484-9107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
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
SCSD3101Medicaid