Healthcare Provider Details

I. General information

NPI: 1184808081
Provider Name (Legal Business Name): FREDERICKSBURG COMM SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2007
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E HIGH ST
FREDERICKSBURG IA
50630-7730
US

IV. Provider business mailing address

401 E HIGH ST PO BOX 337
FREDERICKSBURG IA
50630-7730
US

V. Phone/Fax

Practice location:
  • Phone: 563-237-5364
  • Fax: 563-237-5888
Mailing address:
  • Phone: 563-237-5364
  • Fax: 563-237-5888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateIA

VIII. Authorized Official

Name: MR. RICK PEDERSON
Title or Position: SUPERINTENDENT
Credential:
Phone: 563-237-5364