Healthcare Provider Details

I. General information

NPI: 1366857609
Provider Name (Legal Business Name): TWIGGS COUNTY PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 06/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

952 MAIN ST
JEFFERSONVILLE GA
31044-3727
US

IV. Provider business mailing address

952 MAIN ST
JEFFERSONVILLE GA
31044-3727
US

V. Phone/Fax

Practice location:
  • Phone: 478-945-3127
  • Fax: 478-945-3078
Mailing address:
  • Phone: 478-945-3127
  • Fax: 478-945-3078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BETTY KAY LOWERY
Title or Position: MEDICAID COORDINATOR
Credential:
Phone: 478-374-2240