Provider Demographics
NPI:1245412717
Name:PRINCE GEORGE COUNTY PUBLIC SCHOOLS
Entity type:Organization
Organization Name:PRINCE GEORGE COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACTING SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-733-2700
Mailing Address - Street 1:P.O. BOX 400
Mailing Address - Street 2:6410 COURTS DRIVE
Mailing Address - City:PRINCE GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:23875
Mailing Address - Country:US
Mailing Address - Phone:804-733-2700
Mailing Address - Fax:804-733-2737
Practice Address - Street 1:6410 COURTS DRIVE
Practice Address - Street 2:
Practice Address - City:PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23875
Practice Address - Country:US
Practice Address - Phone:804-733-2700
Practice Address - Fax:804-733-2737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251300000X
VA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004981596Medicaid