Healthcare Provider Details

I. General information

NPI: 1497804272
Provider Name (Legal Business Name): SOUTH TAMA COUNTY COMMUNITY SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 HARDING ST
TAMA IA
52339-1028
US

IV. Provider business mailing address

1702 HARDING ST
TAMA IA
52339-1028
US

V. Phone/Fax

Practice location:
  • Phone: 641-484-4811
  • Fax: 641-484-4861
Mailing address:
  • Phone: 641-484-4811
  • Fax: 641-484-4861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LARRY MOLACEK
Title or Position: SUPERINTENDENT
Credential:
Phone: 641-484-4811