Healthcare Provider Details

I. General information

NPI: 1053644096
Provider Name (Legal Business Name): REPUBLIC COUNTY UNIFIED SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 09/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 19TH ST
BELLEVILLE KS
66935-2756
US

IV. Provider business mailing address

1205 19TH ST
BELLEVILLE KS
66935-2756
US

V. Phone/Fax

Practice location:
  • Phone: 785-527-5621
  • Fax: 785-527-5675
Mailing address:
  • Phone: 785-527-5621
  • Fax: 785-527-5375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MR. TROY DAMMAN
Title or Position: SUPERINTENDENT
Credential:
Phone: 785-527-5621