Basic Information
Provider Information
NPI: 1467478644
EntityType: 2
ReplacementNPI:  
OrganizationName: CULPEPER COUNTY PUBLIC SCHOOLS
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 225 LAMBS LN
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229018951
CountryCode: US
TelephoneNumber: 4349759400
FaxNumber: 4349759401
Practice Location
Address1: 450 RADIO LN
Address2:  
City: CULPEPER
State: VA
PostalCode: 227011521
CountryCode: US
TelephoneNumber: 5408253677
FaxNumber: 5407270985
Other Information
ProviderEnumerationDate: 07/14/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MCMANUS
AuthorizedOfficialFirstName: MARY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: EXECUTIVE DIRECTOR
AuthorizedOfficialTelephone: 4349759400
IsSoleProprietor:  
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: PHD

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251300000X  Y AgenciesLocal Education Agency (LEA) 

ID Information
IDTypeStateIssuerDescription
497989305VA MEDICAID


Home