1821116765 NPI number — BUCKLIN PUBLIC SCHOOLS

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 1821116765 NPI number — BUCKLIN PUBLIC SCHOOLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BUCKLIN PUBLIC SCHOOLS
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:
1821116765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26832 HIGHWAY 129
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUCKLIN
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
64631-9230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
660-695-3555
Provider Business Mailing Address Fax Number:
660-395-3345

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
26832 HIGHWAY 129
Provider Second Line Business Practice Location Address:
BUCKLIN PUBLIC SCHOOLS
Provider Business Practice Location Address City Name:
BUCKLIN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
64631-9230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-695-3555
Provider Business Practice Location Address Fax Number:
660-395-3345
Provider Enumeration Date:
03/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HAYNES
Authorized Official First Name:
JACKIE
Authorized Official Middle Name:
Authorized Official Title or Position:
SUPERINTENDENT SECRETARY
Authorized Official Telephone Number:
660-695-3555

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 506107903 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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