1730222118 NPI number — FORT CHERRY SCHOOL DISTRICT

Table of content: (NPI 1730222118)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730222118 NPI number — FORT CHERRY SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FORT CHERRY 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:
1730222118
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 FORT CHERRY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MC DONALD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15057-2927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-796-1581
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
110 FORT CHERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MC DONALD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15057-2927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-796-1581
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SROKA
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
R
Authorized Official Title or Position:
BUSINESS MANAGER
Authorized Official Telephone Number:
724-796-1551

Provider Taxonomy Codes

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

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

  • Identifier: 0015055280001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".