Healthcare Provider Details

I. General information

NPI: 1598779829
Provider Name (Legal Business Name): PETERSBURG PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 SOUTH BLVD EAST
PETERSBURG VA
23805-2700
US

IV. Provider business mailing address

255 E SOUTH BLVD
PETERSBURG VA
23805-2700
US

V. Phone/Fax

Practice location:
  • Phone: 804-732-0511
  • Fax: 804-957-4837
Mailing address:
  • Phone: 804-732-0511
  • Fax: 804-957-4837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateVA

VIII. Authorized Official

Name: TRACIE COLEMAN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 804-732-0511