Provider Demographics
NPI:1063556041
Name:OTTUMWA COMMUNITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:OTTUMWA COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-684-6597
Mailing Address - Street 1:422 MCCARROLL DR
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-1260
Mailing Address - Country:US
Mailing Address - Phone:641-684-6597
Mailing Address - Fax:641-684-6522
Practice Address - Street 1:422 MCCARROLL DR
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-1260
Practice Address - Country:US
Practice Address - Phone:641-684-6597
Practice Address - Fax:641-684-6522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0224931Medicaid