Healthcare Provider Details

I. General information

NPI: 1073688396
Provider Name (Legal Business Name): DILLION SCHOOL DISTRICT ONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 EAST THIRD AVENUE
LAKE VIEW SC
29563-0644
US

IV. Provider business mailing address

PO BOX 644
LAKE VIEW SC
29563-0644
US

V. Phone/Fax

Practice location:
  • Phone: 843-759-3001
  • Fax: 843-759-3000
Mailing address:
  • Phone: 843-759-3001
  • Fax: 843-759-3000

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: MR. STEPHEN LAIRD
Title or Position: SUPERINTENDENT
Credential:
Phone: 843-759-3001