Provider Demographics
NPI:1295787745
Name:WILLIAMSBURG COUNTY SCHOOL DISTRICT
Entity type:Organization
Organization Name:WILLIAMSBURG COUNTY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-355-5571
Mailing Address - Street 1:423 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-3419
Mailing Address - Country:US
Mailing Address - Phone:843-355-5571
Mailing Address - Fax:843-355-0804
Practice Address - Street 1:500 N ACADEMY ST
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3408
Practice Address - Country:US
Practice Address - Phone:843-355-0894
Practice Address - Fax:843-355-5144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
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
SCSC4501Medicaid