1265729230 NPI number — PRINSBURG COMMON SCHOOL DISTRICT 815

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265729230 NPI number — PRINSBURG COMMON SCHOOL DISTRICT 815

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRINSBURG COMMON SCHOOL DISTRICT 815
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:
Provider Other Organization Name Type Code:
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:
1265729230
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 297
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PRINSBURG
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56281
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-978-6400
Provider Business Mailing Address Fax Number:
320-978-6797

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
106 6TH ST
Provider Second Line Business Practice Location Address:
SPEC ED BLDG
Provider Business Practice Location Address City Name:
PRINSBURG
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56281
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-978-8700
Provider Business Practice Location Address Fax Number:
320-978-6797
Provider Enumeration Date:
06/29/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BREEMS
Authorized Official First Name:
MARGE
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
320-978-4721

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)





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