Healthcare Provider Details

I. General information

NPI: 1306892658
Provider Name (Legal Business Name): PORTAGE AREA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 MOUNTAIN AVE
PORTAGE PA
15946-1809
US

IV. Provider business mailing address

84 MOUNTAIN AVE
PORTAGE PA
15946-1809
US

V. Phone/Fax

Practice location:
  • Phone: 814-736-9636
  • Fax: 814-736-9634
Mailing address:
  • Phone: 814-736-9636
  • Fax: 814-736-9634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL J KUNKO
Title or Position: BUSINESS ADMINISTRATOR
Credential: CFO
Phone: 814-736-9636