Healthcare Provider Details

I. General information

NPI: 1275858086
Provider Name (Legal Business Name): SMETHPORT AREA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2010
Last Update Date: 04/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 S MECHANIC ST
SMETHPORT PA
16749-1522
US

IV. Provider business mailing address

414 S MECHANIC ST
SMETHPORT PA
16749-1522
US

V. Phone/Fax

Practice location:
  • Phone: 814-887-5543
  • Fax: 814-887-5544
Mailing address:
  • Phone: 814-887-5543
  • Fax: 814-887-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. GEORGE J ROMANOWSKI
Title or Position: SUPERINTENDENT
Credential:
Phone: 814-887-5543