1346381019 NPI number — EDEN CENTRAL 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 1346381019 NPI number — EDEN CENTRAL SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EDEN CENTRAL 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:
1346381019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3150 SCHOOLVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDEN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14057-1107
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-992-3606
Provider Business Mailing Address Fax Number:
716-992-3656

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3150 SCHOOLVIEW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDEN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14057-1107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-992-3606
Provider Business Practice Location Address Fax Number:
716-992-3656
Provider Enumeration Date:
02/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
JOHNSON
Authorized Official First Name:
SHAWN
Authorized Official Middle Name:
IONE
Authorized Official Title or Position:
SCHOOL ADMINISTRATOR.DIRECTOR OF PU
Authorized Official Telephone Number:
716-992-3645

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)

  • Identifier: 14120106 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com