Healthcare Provider Details

I. General information

NPI: 1790842649
Provider Name (Legal Business Name): GANANDA CENTRAL SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DAYSPRING RDG
WALWORTH NY
14568-9517
US

IV. Provider business mailing address

PO BOX 609
MACEDON NY
14502-0609
US

V. Phone/Fax

Practice location:
  • Phone: 315-986-3521
  • Fax: 315-986-2003
Mailing address:
  • Phone: 315-986-3521
  • Fax: 315-986-2003

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: PATRICIA MARIE ROACH
Title or Position: SUPERINTENDENT
Credential:
Phone: 315-986-3521