MEDICARE: JEFFERSON COUNTY BOE

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	:	1659434678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFERSON COUNTY BOE

Provider Business Mailing Address
First Line	:	1001 PEACHTREE ST
Second Line	:
City	:	LOUISVILLE
State	:	GA
Zip	:	30434-1523
Country	:	US
Telephone Number	:	478-625-7626
Fax Number	:	478-625-7459

Provider Business Practice Location Address
First Line	:	1001 PEACHTREE ST
Second Line	:
City	:	LOUISVILLE
State	:	GA
Zip	:	30434-1523
Country	:	US
Telephone Number	:	478-625-7626
Fax Number	:	478-625-7459

Authorized Official
Title or Position	:	SPECIAL EDUCATION DIRECTOR
Name	:	MRS. BARBARA THOMAS
Credential	:
Telephone Number	:	478-625-7626

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	08/22/2020

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