Provider Demographics
NPI:1073646444
Name:BUNKER R-III SCHOOL
Entity type:Organization
Organization Name:BUNKER R-III SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR SPECIAL EDUCATION
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:573-689-2211
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:BUNKER
Mailing Address - State:MO
Mailing Address - Zip Code:63629-0365
Mailing Address - Country:US
Mailing Address - Phone:573-689-2211
Mailing Address - Fax:573-689-2011
Practice Address - Street 1:HWY 72 & EAGLE PRIDE DRIVE
Practice Address - Street 2:
Practice Address - City:BUNKER
Practice Address - State:MO
Practice Address - Zip Code:63629-0365
Practice Address - Country:US
Practice Address - Phone:573-689-2211
Practice Address - Fax:573-689-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO090077Medicaid