Healthcare Provider Details

I. General information

NPI: 1669539995
Provider Name (Legal Business Name): BAINBRIDGE-GUILFORD CENTRAL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 JULIAND ST.
BAINBRIDGE NY
13733
US

IV. Provider business mailing address

18 JULIAND ST.
BAINBRIDGE NY
13733
US

V. Phone/Fax

Practice location:
  • Phone: 607-967-6300
  • Fax: 607-967-4231
Mailing address:
  • Phone: 607-967-6300
  • Fax: 607-967-4231

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. KARL L BROWN
Title or Position: SUPERINTENDENT
Credential: SDA
Phone: 607-967-6321