Provider Demographics
NPI:1588748743
Name:HANOVER COUNTY PUBLIC SCHOOLS
Entity type:Organization
Organization Name:HANOVER COUNTY PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL SYSTEMS SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:E
Authorized Official - Last Name:DORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-365-4576
Mailing Address - Street 1:200 BERKLEY STREET
Mailing Address - Street 2:HEALTH SERVICES
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005
Mailing Address - Country:US
Mailing Address - Phone:804-365-4556
Mailing Address - Fax:804-365-4680
Practice Address - Street 1:200 BERKLEY ST
Practice Address - Street 2:HEALTH SERVICES
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1302
Practice Address - Country:US
Practice Address - Phone:804-365-4556
Practice Address - Fax:804-365-4680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA690530042251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4979265Medicaid