Healthcare Provider Details

I. General information

NPI: 1740118314
Provider Name (Legal Business Name): COLUMBIA COUNTY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 WEST DUVAL STREET
LAKE CITY FL
32055-3990
US

IV. Provider business mailing address

372 WEST DUVAL STREET
LAKE CITY FL
32055-3990
US

V. Phone/Fax

Practice location:
  • Phone: 386-755-8012
  • Fax:
Mailing address:
  • Phone: 386-755-8012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: BONNIE PENNER
Title or Position: CFO
Credential:
Phone: 386-755-8000