Provider Demographics
NPI:1992850390
Name:BOARD OF EDUCATION OF FULTON KENTUCKY
Entity Type:Organization
Organization Name:BOARD OF EDUCATION OF FULTON KENTUCKY
Other - Org Name:FULTON INDEPENDENT SCHOOL DIST.
Other - Org Type:Other Name
Authorized Official - Title/Position:DOSE
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-472-1553
Mailing Address - Street 1:304 W. STATE LINE ROAD
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:KY
Mailing Address - Zip Code:42041-1547
Mailing Address - Country:US
Mailing Address - Phone:270-472-1553
Mailing Address - Fax:270-472-6921
Practice Address - Street 1:304 W. STATE LINE ROAD
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:KY
Practice Address - Zip Code:42041-1547
Practice Address - Country:US
Practice Address - Phone:270-472-1553
Practice Address - Fax:270-472-6921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21038013Medicaid