1245403583 NPI number — WAUSAUKEE SCHOOL DISTRICT

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 1245403583 NPI number — WAUSAUKEE SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WAUSAUKEE SCHOOL DISTRICT
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:
1245403583
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N11941 US HIGHWAY 141
Provider Second Line Business Mailing Address:
PO BOX 258
Provider Business Mailing Address City Name:
WAUSAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54177-9300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-856-5151
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N11941 US HIGHWAY 141
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAUSAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54177-9300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-856-5151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DOOLEY
Authorized Official First Name:
JAN
Authorized Official Middle Name:
Authorized Official Title or Position:
DISTRICT ADMINISTRATOR
Authorized Official Telephone Number:
715-856-5151

Provider Taxonomy Codes

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

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

  • Identifier: 44241300 . This is a "MEDICAID BILLING PROVIDER" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




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