1760551147 NPI number — MCLAUGHLIN SCHOOL DISTRICT 15-2

Table of content: (NPI 1760551147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760551147 NPI number — MCLAUGHLIN SCHOOL DISTRICT 15-2

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCLAUGHLIN SCHOOL DISTRICT 15-2
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:
1760551147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 SOUTH MAIN
Provider Second Line Business Mailing Address:
P.O. BOX 880
Provider Business Mailing Address City Name:
MCLAUGHLIN
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57642-0880
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-823-4483
Provider Business Mailing Address Fax Number:
604-823-4880

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 SOUTH MAIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MCLAUGHLIN
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57642-0880
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-823-4483
Provider Business Practice Location Address Fax Number:
604-823-4880
Provider Enumeration Date:
11/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANDQUIST
Authorized Official First Name:
KENDRA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
605-823-4484

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  R015731 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 5150670 . This is a "PIN" identifier , issued by the state of ( SD ) . This identifiers is of the category "OTHER".