Healthcare Provider Details

I. General information

NPI: 1528198256
Provider Name (Legal Business Name): SOUTHWESTERN CENTRAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HUNT RD
JAMESTOWN NY
14701-5722
US

IV. Provider business mailing address

600 HUNT RD.
JAMESTOWN NY
14701-5722
US

V. Phone/Fax

Practice location:
  • Phone: 716-484-1136
  • Fax: 716-488-3121
Mailing address:
  • Phone: 716-484-6889
  • Fax: 716-488-2442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number060201060000
License Number StateNY

VIII. Authorized Official

Name: MRS. MAUREEN DONAHUE
Title or Position: SUPERINTENDENT
Credential:
Phone: 716-484-1136