Healthcare Provider Details

I. General information

NPI: 1265653455
Provider Name (Legal Business Name): CORINTH SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MEEKS ST EAST CORINTH ELMENTARY SCHOOL
CORINTH MS
38834-4357
US

IV. Provider business mailing address

1204 N HARPER RD
CORINTH MS
38834-4500
US

V. Phone/Fax

Practice location:
  • Phone: 662-286-5245
  • Fax: 662-286-1885
Mailing address:
  • Phone: 662-287-2425
  • Fax: 662-286-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR857078
License Number StateMS

VIII. Authorized Official

Name: DR. LEE CHILDRESS
Title or Position: SUPERINTENDENT
Credential: ED.D.
Phone: 662-287-2425