1487887170 NPI number — MASCENIC REGIONAL SCHOOL DISTRICT/SAU 87

Table of content: (NPI 1487887170)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487887170 NPI number — MASCENIC REGIONAL SCHOOL DISTRICT/SAU 87

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MASCENIC REGIONAL SCHOOL DISTRICT/SAU 87
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:
1487887170
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 TRICNIT RD
Provider Second Line Business Mailing Address:
SUITE #5
Provider Business Mailing Address City Name:
NEW IPSWICH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03071-3447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-721-0169
Provider Business Mailing Address Fax Number:
603-721-0183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 TRICNIT RD
Provider Second Line Business Practice Location Address:
SUITE #5
Provider Business Practice Location Address City Name:
NEW IPSWICH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03071-3447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-721-0169
Provider Business Practice Location Address Fax Number:
603-721-0183
Provider Enumeration Date:
08/27/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DREYER
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
DIRECTOR, STUDENT SUPPORT SERVICES
Authorized Official Telephone Number:
603-721-0169

Provider Taxonomy Codes

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

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

  • Identifier: 5004143 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".