Provider Demographics
NPI:1942367909
Name:PERRY COUNTY SCHOOLS
Entity Type:Organization
Organization Name:PERRY COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-439-5813
Mailing Address - Street 1:315 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9548
Mailing Address - Country:US
Mailing Address - Phone:606-439-5813
Mailing Address - Fax:606-439-2512
Practice Address - Street 1:315 PARK AVE
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9548
Practice Address - Country:US
Practice Address - Phone:606-439-5813
Practice Address - Fax:606-439-2512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
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
KY21097019Medicaid