Healthcare Provider Details

I. General information

NPI: 1326313156
Provider Name (Legal Business Name): ZUMBROTA-MAZEPPA PUBLIC SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2012
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 3RD AVE NE
MAZEPPA MN
55956-3170
US

IV. Provider business mailing address

343 3RD AVE NE
MAZEPPA MN
55956-3170
US

V. Phone/Fax

Practice location:
  • Phone: 507-843-4194
  • Fax: 507-843-4086
Mailing address:
  • Phone: 507-843-4194
  • Fax: 507-843-4086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TONY SIMONS
Title or Position: SUPERINTENDENT
Credential:
Phone: 507-843-4080