Healthcare Provider Details

I. General information

NPI: 1518973288
Provider Name (Legal Business Name): WYTHE COUNTY PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1570 W RESERVOIR ST
WYTHEVILLE VA
24382-1500
US

IV. Provider business mailing address

1570 W RESERVOIR ST
WYTHEVILLE VA
24382-1500
US

V. Phone/Fax

Practice location:
  • Phone: 276-228-5411
  • Fax: 276-228-5411
Mailing address:
  • Phone: 276-228-5411
  • Fax: 276-228-5411

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: DR. MELINDA R HOGE
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 276-228-5411