Provider Demographics
NPI:1740484013
Name:MADISON COUNTY SCHOOLS
Entity type:Organization
Organization Name:MADISON COUNTY SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROGRAMS COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-853-1326
Mailing Address - Street 1:212 SUNNYBROOK RD.
Mailing Address - Street 2:OFFICE OF SPECIAL SERVICES
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157
Mailing Address - Country:US
Mailing Address - Phone:601-853-1326
Mailing Address - Fax:601-853-7610
Practice Address - Street 1:212 SUNNYBROOK RD.
Practice Address - Street 2:OFFICE OF SPECIAL SERVICES
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157
Practice Address - Country:US
Practice Address - Phone:601-853-1326
Practice Address - Fax:601-853-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
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
MS09015492Medicaid