Provider Demographics
NPI:1548320666
Name:SEMINOLE COUNTY BOARD OF EDUCATION
Entity type:Organization
Organization Name:SEMINOLE COUNTY BOARD OF EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-884-9900
Mailing Address - Street 1:800 S WOOLFORK AVE
Mailing Address - Street 2:
Mailing Address - City:DONALSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:39845-1900
Mailing Address - Country:US
Mailing Address - Phone:229-524-2433
Mailing Address - Fax:229-524-2112
Practice Address - Street 1:800 S WOOLFORK AVE
Practice Address - Street 2:
Practice Address - City:DONALSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:39845-1900
Practice Address - Country:US
Practice Address - Phone:229-524-2433
Practice Address - Fax:229-524-2112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251300000XAgenciesLocal Education Agency (LEA)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000786189AMedicaid