Provider Demographics
NPI:1780711390
Name:CLOVERPORT INDEPENDENT SCHOOL DISTRICT
Entity type:Organization
Organization Name:CLOVERPORT INDEPENDENT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-788-3910
Mailing Address - Street 1:214 W MAIN ST
Mailing Address - Street 2:P.O. BOX 37
Mailing Address - City:CLOVERPORT
Mailing Address - State:KY
Mailing Address - Zip Code:40111-1341
Mailing Address - Country:US
Mailing Address - Phone:270-788-3910
Mailing Address - Fax:270-788-6290
Practice Address - Street 1:101 4TH ST
Practice Address - Street 2:
Practice Address - City:CLOVERPORT
Practice Address - State:KY
Practice Address - Zip Code:40111-1307
Practice Address - Country:US
Practice Address - Phone:270-788-3910
Practice Address - Fax:270-788-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
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
KY2101402200Medicaid