Provider Demographics
NPI:1427260611
Name:SOUTH PIKE SCHOOL DISTRICT
Entity type:Organization
Organization Name:SOUTH PIKE SCHOOL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DISTRICT SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUNNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-783-3742
Mailing Address - Street 1:1175 NORTH CLARK ST
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:MS
Mailing Address - Zip Code:39652
Mailing Address - Country:US
Mailing Address - Phone:601-783-5983
Mailing Address - Fax:601-783-2055
Practice Address - Street 1:1175 NORTH CLARK ST
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:MS
Practice Address - Zip Code:39652
Practice Address - Country:US
Practice Address - Phone:601-783-5983
Practice Address - Fax:601-783-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR869794163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03489201Medicaid