Provider Demographics
NPI:1306010012
Name:VIROQUA AREA SCHOOL DISTRICT
Entity type:Organization
Organization Name:VIROQUA AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KNADLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:608-637-1187
Mailing Address - Street 1:115 N EDUCATION AVE
Mailing Address - Street 2:
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-1318
Mailing Address - Country:US
Mailing Address - Phone:608-637-1186
Mailing Address - Fax:608-637-8554
Practice Address - Street 1:115 N EDUCATION AVE
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-1318
Practice Address - Country:US
Practice Address - Phone:608-637-1186
Practice Address - Fax:608-637-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44215200Medicaid