1164626529 NPI number — TOWN OF MADAWASKA SCHOOL DEPARTMENT

Table of content: (NPI 1164626529)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164626529 NPI number — TOWN OF MADAWASKA SCHOOL DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF MADAWASKA SCHOOL DEPARTMENT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TOWN OF MADAWASKA SCHOOL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164626529
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/14/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
135-7TH AVENUE
Provider Second Line Business Mailing Address:
MADAWASKA SCHOOL DEPARTMENT
Provider Business Mailing Address City Name:
MADAWASKA
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-728-3371
Provider Business Mailing Address Fax Number:
207-728-3636

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
135 7TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MADAWASKA
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04756-1159
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-728-3371
Provider Business Practice Location Address Fax Number:
207-728-3636
Provider Enumeration Date:
06/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CASTONGUAY
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
SPECIAL EDUCATION DIRECTOR
Authorized Official Telephone Number:
207-728-3371

Provider Taxonomy Codes

  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1030260000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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