Healthcare Provider Details

I. General information

NPI: 1407900731
Provider Name (Legal Business Name): BERNIE R-XIII SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 W MAIN AVE
BERNIE MO
63822-9575
US

IV. Provider business mailing address

516 W MAIN AVE
BERNIE MO
63822-9575
US

V. Phone/Fax

Practice location:
  • Phone: 573-293-5333
  • Fax: 573-293-5731
Mailing address:
  • Phone: 573-293-5333
  • Fax: 573-293-5731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. RHONDA L SHIPMAN
Title or Position: BOOKKEEPER
Credential:
Phone: 573-293-5333