Provider Demographics
NPI:1922026475
Name:WASHINGTON COUNTY PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:WASHINGTON COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-739-3043
Mailing Address - Street 1:812 THOMPSON DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24210-2346
Mailing Address - Country:US
Mailing Address - Phone:276-739-3043
Mailing Address - Fax:276-628-1883
Practice Address - Street 1:812 THOMPSON DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-2346
Practice Address - Country:US
Practice Address - Phone:276-739-3043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2014-05-06
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2014-05-06
Provider Licenses
StateLicense IDTaxonomies
VA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004979435Medicaid