1396929626 NPI number — SCHOOL DISTRICT OF CAMBRIDGE

Table of content: (NPI 1396929626)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396929626 NPI number — SCHOOL DISTRICT OF CAMBRIDGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHOOL DISTRICT OF CAMBRIDGE
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:
1396929626
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
403 BLUE JAY WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53523-9547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
608-423-9869

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
403 BLUE JAY WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53523-9547
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-423-4345
Provider Business Practice Location Address Fax Number:
608-423-9869
Provider Enumeration Date:
12/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MAEDKE
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
608-423-4345

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: 44216600 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com