1740223908 NPI number — SHANKSVILLE-STONYCREEK SCHOOL DISTRICT

Table of content: (NPI 1740223908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740223908 NPI number — SHANKSVILLE-STONYCREEK SCHOOL DISTRICT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHANKSVILLE-STONYCREEK 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:
1740223908
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/09/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 128
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHANKSVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15560-0128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-267-4649
Provider Business Mailing Address Fax Number:
814-267-4372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1325 CORNER STONE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRIEDENS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15541-6157
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-267-4649
Provider Business Practice Location Address Fax Number:
814-267-4372
Provider Enumeration Date:
06/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROMESBERG
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
JAMES
Authorized Official Title or Position:
SUPERINTENDENT
Authorized Official Telephone Number:
814-267-4649

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: 0014119500001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".