Provider Demographics
NPI:1396911749
Name:BARNEVELD SCHOOL DISTRICT
Entity type:Organization
Organization Name:BARNEVELD SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-924-4711
Mailing Address - Street 1:105 W DOUGLAS ST
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:WI
Mailing Address - Zip Code:53507-9326
Mailing Address - Country:US
Mailing Address - Phone:608-924-4711
Mailing Address - Fax:608-924-1646
Practice Address - Street 1:105 W DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:BARNEVELD
Practice Address - State:WI
Practice Address - Zip Code:53507-9326
Practice Address - Country:US
Practice Address - Phone:608-924-4711
Practice Address - Fax:608-924-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44234100Medicaid