Healthcare Provider Details

I. General information

NPI: 1538371265
Provider Name (Legal Business Name): GRAND MEADOW SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 4TH AVE NE
GRAND MEADOW MN
55936-8683
US

IV. Provider business mailing address

PO BOX 68
GRAND MEADOW MN
55936-0068
US

V. Phone/Fax

Practice location:
  • Phone: 507-754-5318
  • Fax: 507-754-5608
Mailing address:
  • Phone: 507-754-5318
  • Fax: 507-754-5608

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. JOSEPH BROWN
Title or Position: SUPERINTENDANT
Credential:
Phone: 507-754-5318