Provider Demographics
NPI:1104983402
Name:BOYD COUNTY PUBLIC SCHOOLS
Entity type:Organization
Organization Name:BOYD COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID LIAISON
Authorized Official - Prefix:MS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-929-1160
Mailing Address - Street 1:12219 MIDLAND TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41102-7766
Mailing Address - Country:US
Mailing Address - Phone:606-929-1160
Mailing Address - Fax:606-928-2685
Practice Address - Street 1:12219 MIDLAND TRAIL RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-7766
Practice Address - Country:US
Practice Address - Phone:606-929-1160
Practice Address - Fax:606-928-2685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21010012251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY21010012Medicare ID - Type Unspecified