Healthcare Provider Details

I. General information

NPI: 1821202110
Provider Name (Legal Business Name): LINCOLN PARISH SCHOOL BOARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S FARMERVILLE ST
RUSTON LA
71270-4655
US

IV. Provider business mailing address

410 S FARMERVILLE ST
RUSTON LA
71270-4655
US

V. Phone/Fax

Practice location:
  • Phone: 318-251-9082
  • Fax:
Mailing address:
  • Phone: 318-251-9082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1499999
Identifier TypeMEDICAID
Identifier StateLA
Identifier Issuer

VIII. Authorized Official

Name: MR. DANNY L. BELL
Title or Position: SUPERINTENDENT
Credential:
Phone: 318-251-9082