Provider Demographics
NPI:1881185999
Name:ST. MATTHEWS K-8 SCHOOL
Entity Type:Organization
Organization Name:ST. MATTHEWS K-8 SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:803-531-6900
Mailing Address - Street 1:3310 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29115-1466
Mailing Address - Country:US
Mailing Address - Phone:803-531-6900
Mailing Address - Fax:803-531-6907
Practice Address - Street 1:132 SAINTS AVENUE
Practice Address - Street 2:
Practice Address - City:ST .MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135
Practice Address - Country:US
Practice Address - Phone:803-655-2750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY HEALTH CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty