=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730586371
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOGALUSA CITY SCHOOLS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2014
-----------------------------------------------------
Last Update Date | 11/25/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 M J ISRAEL DR
-----------------------------------------------------
City | BOGALUSA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70427-3757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-281-2154
-----------------------------------------------------
Fax | 985-545-1003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 M J ISRAEL DR
-----------------------------------------------------
City | BOGALUSA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70427-3757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-281-2154
-----------------------------------------------------
Fax | 985-545-1003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | KATASHA AUGUST
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 985-281-2155
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QS1000X
-----------------------------------------------------
Taxonomy Name | Student Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------