Healthcare Provider Details

I. General information

NPI: 1093497380
Provider Name (Legal Business Name): ELWOOD PUBLIC SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 08/04/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 1ST AVE
ELWOOD NE
68937-5208
US

IV. Provider business mailing address

PO BOX 107
ELWOOD NE
68937-0107
US

V. Phone/Fax

Practice location:
  • Phone: 308-785-2491
  • Fax:
Mailing address:
  • Phone: 308-785-2491
  • Fax:

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. DAREN L HATCH
Title or Position: SUPERINTENDENT
Credential:
Phone: 308-785-2491