Provider Demographics
NPI:1285791566
Name:BOARD OF EDUCATION OF WICOMICO COUNTY
Entity type:Organization
Organization Name:BOARD OF EDUCATION OF WICOMICO COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HANLIN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:410-677-4400
Mailing Address - Street 1:101 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5045
Mailing Address - Country:US
Mailing Address - Phone:410-677-4400
Mailing Address - Fax:410-677-4489
Practice Address - Street 1:101 LONG AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5045
Practice Address - Country:US
Practice Address - Phone:410-677-5250
Practice Address - Fax:410-677-4489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD407974400Medicaid