Provider Demographics
NPI:1902079817
Name:MONROE COUNTY BOARD OF EDUCATION
Entity Type:Organization
Organization Name:MONROE COUNTY BOARD OF EDUCATION
Other - Org Name:COORDINATED SCHOOL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF SCHOOL SYSTEM
Authorized Official - Prefix:MS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:423-442-2373
Mailing Address - Street 1:205 OAK GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37354-5930
Mailing Address - Country:US
Mailing Address - Phone:423-420-9678
Mailing Address - Fax:423-442-5276
Practice Address - Street 1:121 OLD HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:TELLICO PLAINS
Practice Address - State:TN
Practice Address - Zip Code:37385-4965
Practice Address - Country:US
Practice Address - Phone:423-253-3875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506898Medicaid