MEDICARE: BARNWELL SCHOOL DISTRICT #29

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1568531366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARNWELL SCHOOL DISTRICT #29

Provider Business Mailing Address
First Line	:	12255 MAIN ST
Second Line	:	WILLISTON SCHOOL DISTRICT 29
City	:	WILLISTON
State	:	SC
Zip	:	29853-2803
Country	:	US
Telephone Number	:	803-266-7878
Fax Number	:	803-266-3879

Provider Business Practice Location Address
First Line	:	12255 MAIN ST
Second Line	:	WILLISTON SCHOOL DISTRICT 29
City	:	WILLISTON
State	:	SC
Zip	:	29853-2803
Country	:	US
Telephone Number	:	803-266-7878
Fax Number	:	803-266-3879

Authorized Official
Title or Position	:	DIRECTOR OF SPECIAL SERVICES
Name	:	MS. GLORIA GRAMLING SMITH
Credential	:	SCHOOL PSYCHOLOGIST
Telephone Number	:	803-266-7878

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	08/22/2020

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