Provider Demographics
NPI:1356366801
Name:APPOMATTOX COUNTY PUBLIC SCHOOLS
Entity type:Organization
Organization Name:APPOMATTOX COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OF REMEDIAL AND SPECIAL EDUCAT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORINDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRASTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-352-8251
Mailing Address - Street 1:316 COURT STREET
Mailing Address - Street 2:
Mailing Address - City:APPOMATTOX
Mailing Address - State:VA
Mailing Address - Zip Code:24522
Mailing Address - Country:US
Mailing Address - Phone:434-352-8251
Mailing Address - Fax:434-352-0883
Practice Address - Street 1:316 COURT STREET
Practice Address - Street 2:
Practice Address - City:APPOMATTOX
Practice Address - State:VA
Practice Address - Zip Code:24522
Practice Address - Country:US
Practice Address - Phone:434-352-8251
Practice Address - Fax:434-352-0883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA004981278251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004981278Medicaid