Provider Demographics
NPI:1790833499
Name:PENDLETON COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:PENDLETON COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-654-6911
Mailing Address - Street 1:2525 US HIGHWAY 27 N
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:KY
Mailing Address - Zip Code:41040-8851
Mailing Address - Country:US
Mailing Address - Phone:859-654-6911
Mailing Address - Fax:859-654-6143
Practice Address - Street 1:2525 US HIGHWAY 27 N
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:KY
Practice Address - Zip Code:41040-8851
Practice Address - Country:US
Practice Address - Phone:859-654-6911
Practice Address - Fax:859-654-6143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21096011Medicaid