Provider Demographics
NPI: | 1588944730 |
---|---|
Name: | KEYA PAHA COUNTY SCHOOL |
Entity type: | Organization |
Organization Name: | KEYA PAHA COUNTY SCHOOL |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | SECRETARY/BOOKKEEPER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | CHARLENE |
Authorized Official - Middle Name: | L |
Authorized Official - Last Name: | SWIM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 402-497-3501 |
Mailing Address - Street 1: | 101 FOOTBALL AVENUE |
Mailing Address - Street 2: | BOX 219 |
Mailing Address - City: | SPRINGVIEW |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68778-0219 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-497-3501 |
Mailing Address - Fax: | 402-497-4321 |
Practice Address - Street 1: | 101 FOOTBALL AVENUE |
Practice Address - Street 2: | |
Practice Address - City: | SPRINGVIEW |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68778 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-497-3501 |
Practice Address - Fax: | 402-497-4321 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-08-19 |
Last Update Date: | 2011-08-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251300000X | Agencies | Local Education Agency (LEA) |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NE | =========-68 | Medicare PIN |