Healthcare Provider Details

I. General information

NPI: 1619152790
Provider Name (Legal Business Name): WAYNE COUNTY SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CHICKASAWHAY ST
WAYNESBORO MS
39367-2628
US

IV. Provider business mailing address

810 CHICKASAWHAY ST
WAYNESBORO MS
39367-2628
US

V. Phone/Fax

Practice location:
  • Phone: 601-735-5151
  • Fax: 601-735-7168
Mailing address:
  • Phone: 601-735-5151
  • Fax: 601-735-7168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberNA
License Number StateMS

VIII. Authorized Official

Name: MR. R P STATEN
Title or Position: SUPERINTENDENT OF EDUCATION
Credential:
Phone: 601-735-5151