Provider Demographics
NPI:1801170311
Name:BOLTON EDWARDS ELEMENTARY MIDDLE SCHOOL
Entity type:Organization
Organization Name:BOLTON EDWARDS ELEMENTARY MIDDLE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-857-5222
Mailing Address - Street 1:9700 I 20
Mailing Address - Street 2:
Mailing Address - City:BOLTON
Mailing Address - State:MS
Mailing Address - Zip Code:39041-9126
Mailing Address - Country:US
Mailing Address - Phone:601-866-2522
Mailing Address - Fax:601-866-2524
Practice Address - Street 1:9700 I 20
Practice Address - Street 2:
Practice Address - City:BOLTON
Practice Address - State:MS
Practice Address - Zip Code:39041-9126
Practice Address - Country:US
Practice Address - Phone:601-866-2522
Practice Address - Fax:601-866-2524
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HINDS COUNTY SCHOOL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR867636163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty