Provider Demographics
NPI:1790833556
Name:MCCRACKEN COUNTY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:MCCRACKEN COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOHNNA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:DEJARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-538-4000
Mailing Address - Street 1:5347 BENTON RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-0912
Mailing Address - Country:US
Mailing Address - Phone:270-538-4000
Mailing Address - Fax:
Practice Address - Street 1:5347 BENTON RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-0912
Practice Address - Country:US
Practice Address - Phone:270-538-4000
Practice Address - Fax:270-538-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21073028Medicaid