Provider Demographics
NPI:1154371938
Name:RICHLAND SCHOOL DISTRICT TWO
Entity type:Organization
Organization Name:RICHLAND SCHOOL DISTRICT TWO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOURIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-738-3309
Mailing Address - Street 1:6831 BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29206-2205
Mailing Address - Country:US
Mailing Address - Phone:803-738-3309
Mailing Address - Fax:803-738-3308
Practice Address - Street 1:6831 BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29206-2205
Practice Address - Country:US
Practice Address - Phone:803-738-3309
Practice Address - Fax:803-738-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSD4002Medicaid