Provider Demographics
NPI:1528115615
Name:JAMESTOWN CITY SCHOOL DISTRICT
Entity type:Organization
Organization Name:JAMESTOWN CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:O
Authorized Official - Last Name:MAINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-483-4420
Mailing Address - Street 1:197 MARTIN RD
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701
Mailing Address - Country:US
Mailing Address - Phone:716-483-4420
Mailing Address - Fax:716-483-4278
Practice Address - Street 1:197 MARTIN RD
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701
Practice Address - Country:US
Practice Address - Phone:716-483-4420
Practice Address - Fax:716-483-4278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01367371Medicaid