Healthcare Provider Details

I. General information

NPI: 1477880789
Provider Name (Legal Business Name): ROQUE BLUFFS SCHOOL DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 COURT ST
MACHIAS ME
04654-3304
US

IV. Provider business mailing address

291 COURT ST
MACHIAS ME
04654-3304
US

V. Phone/Fax

Practice location:
  • Phone: 207-255-6585
  • Fax: 207-255-8054
Mailing address:
  • Phone: 207-255-6585
  • Fax: 207-255-8054

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: SCOTT K PORTER
Title or Position: SUPERINTENDENT
Credential:
Phone: 207-255-6585