Provider Demographics
NPI:1699975359
Name:ANACONDA SCHOOL DISTRICT
Entity type:Organization
Organization Name:ANACONDA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHEALON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-563-6361
Mailing Address - Street 1:400 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANACONDA
Mailing Address - State:MT
Mailing Address - Zip Code:59711-2933
Mailing Address - Country:US
Mailing Address - Phone:406-563-6361
Mailing Address - Fax:406-563-6333
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:
Practice Address - City:ANACONDA
Practice Address - State:MT
Practice Address - Zip Code:59711-2933
Practice Address - Country:US
Practice Address - Phone:406-563-6361
Practice Address - Fax:406-563-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0165906Medicaid
MT0165903Medicaid
MT0164632Medicaid
MT0166556Medicaid
MT0165893Medicaid