Healthcare Provider Details
I. General information
NPI: 1639400856
Provider Name (Legal Business Name): USD 273
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2020 NORTH INDEPENDENCE
BELOIT KS
67420-0547
US
IV. Provider business mailing address
P.O. BOX 547
BELOIT KS
67420-0547
US
V. Phone/Fax
- Phone: 785-738-3261
- Fax: 785-738-4103
- Phone: 785-738-3261
- Fax: 785-738-4103
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1000X |
| Taxonomy | Student Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KAREN
S.
NIEMCZYK
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 785-738-5275