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General NPI Number Information
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NPI Number | 1912057704
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Entity Type | Organization
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Legal Business Name | WEST BOLIVAR SCHOOL DISTRICT
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1212 SOUTH MAIN STREET
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City | ROSEDALE
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State | MS
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Zip | 38769-0159
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Country | US
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Telephone | 662-759-3743
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 SOUTH MAIN STREET P.O. BOX 159
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City | ROSEDALE
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State | MS
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Zip | 38769-0159
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Country | US
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Telephone | 662-759-3743
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Fax |
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | MR. HENRY PHILLIPS
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Credential |
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Telephone | 662-759-3525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | R865655
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License Number State | MS
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