Healthcare Provider Details

I. General information

NPI: 1427110949
Provider Name (Legal Business Name): SUNMAN-DEARBORN COMMUNITY SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26022 LAWRENCEVILLE RD.
SUNMAN IN
47041
US

IV. Provider business mailing address

26022 LAWRENCEVILLE RD.
SUNMAN IN
47041
US

V. Phone/Fax

Practice location:
  • Phone: 812-362-2291
  • Fax: 812-623-3341
Mailing address:
  • Phone: 812-362-2291
  • Fax: 812-623-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. JOHN G. ROEDER
Title or Position: SUPERINTENDENT
Credential:
Phone: 812-623-2291