Provider Demographics
NPI:1972652360
Name:POLAND CENTRAL SCHOOL
Entity type:Organization
Organization Name:POLAND CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-826-0204
Mailing Address - Street 1:74 COLD BROOK ST.
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13431
Mailing Address - Country:US
Mailing Address - Phone:315-826-0205
Mailing Address - Fax:315-826-7516
Practice Address - Street 1:74 COLD BROOK ST.
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:NY
Practice Address - Zip Code:13431
Practice Address - Country:US
Practice Address - Phone:315-826-0205
Practice Address - Fax:315-826-7516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01423909Medicaid