Provider Demographics
NPI:1972639383
Name:TRIMBLE COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:TRIMBLE COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:EASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-663-0024
Mailing Address - Street 1:116 WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:KY
Mailing Address - Zip Code:40006-1004
Mailing Address - Country:US
Mailing Address - Phone:502-255-3201
Mailing Address - Fax:502-633-0111
Practice Address - Street 1:116 WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:KY
Practice Address - Zip Code:40006-1004
Practice Address - Country:US
Practice Address - Phone:502-255-3201
Practice Address - Fax:502-633-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21112016Medicaid