1225345051 NPI number — E-STEM MIDDLE PUBLIC CHARTER SCHOOLS, INC

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 1225345051 NPI number — E-STEM MIDDLE PUBLIC CHARTER SCHOOLS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
E-STEM MIDDLE PUBLIC CHARTER SCHOOLS, INC
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:
1225345051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 RIVER MARKET AVE
Provider Second Line Business Mailing Address:
SUITE 225
Provider Business Mailing Address City Name:
LITTLE ROCK
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72201-1752
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-324-9200
Provider Business Mailing Address Fax Number:
501-324-9201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 RIVER MARKET AVE
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72201-1752
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-324-9200
Provider Business Practice Location Address Fax Number:
501-324-9201
Provider Enumeration Date:
08/31/2010

Additional Information

Authorized Official

Authorized Official Last Name:
PETERSON
Authorized Official First Name:
ALLYSON
Authorized Official Middle Name:
L
Authorized Official Title or Position:
SCHOOL NURSE
Authorized Official Telephone Number:
501-748-9206

Provider Taxonomy Codes

  • Taxonomy code: 251300000X , with the licence number:  6046700 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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