Provider Demographics
NPI:1538228853
Name:DISTRICT NO 547
Entity type:Organization
Organization Name:DISTRICT NO 547
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BALDRY
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALIST
Authorized Official - Phone:218-338-6011
Mailing Address - Street 1:411 S OTTER AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERS PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:56361-4504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:411 S OTTER AVE
Practice Address - Street 2:
Practice Address - City:PARKERS PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:56361-4504
Practice Address - Country:US
Practice Address - Phone:218-338-6011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN492488600Medicaid