1912173584 NPI number — SCHOOL DISTRICT OF CUBA CITY

Table of content: (NPI 1912173584)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912173584 NPI number — SCHOOL DISTRICT OF CUBA CITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHOOL DISTRICT OF CUBA CITY
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:
1912173584
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
518 W ROOSEVELT ST
Provider Second Line Business Mailing Address:
101 N. SCHOOL STREET
Provider Business Mailing Address City Name:
CUBA CITY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53807-1220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-744-2174
Provider Business Mailing Address Fax Number:
608-744-7469

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
518 W ROOSEVELT ST
Provider Second Line Business Practice Location Address:
101 N. SCHOOL STREET
Provider Business Practice Location Address City Name:
CUBA CITY
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53807-1220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-744-2174
Provider Business Practice Location Address Fax Number:
608-744-7469
Provider Enumeration Date:
05/05/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DURLEY
Authorized Official First Name:
DEB
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION DESIGNEE
Authorized Official Telephone Number:
608-744-2174

Provider Taxonomy Codes

  • Taxonomy code: 347B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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