Provider Demographics
NPI:1306998083
Name:EDMESTON CENTRAL SCHOOL
Entity type:Organization
Organization Name:EDMESTON CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL EDUCATION
Authorized Official - Prefix:
Authorized Official - First Name:MARYELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-965-8931
Mailing Address - Street 1:PO BOX 5129
Mailing Address - Street 2:11 NORTH STREET
Mailing Address - City:EDMESTON
Mailing Address - State:NY
Mailing Address - Zip Code:13335-0529
Mailing Address - Country:US
Mailing Address - Phone:607-965-8931
Mailing Address - Fax:607-965-8942
Practice Address - Street 1:1113 NORTH STREET
Practice Address - Street 2:
Practice Address - City:EDMESTON
Practice Address - State:NY
Practice Address - Zip Code:13335-0529
Practice Address - Country:US
Practice Address - Phone:607-965-8931
Practice Address - Fax:607-965-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
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
NY01379675Medicaid