Healthcare Provider Details

I. General information

NPI: 1427084821
Provider Name (Legal Business Name): SOUTH WILLIAMSPORT AREA SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W CENTRAL AVE
WILLIAMSPORT PA
17702-7284
US

IV. Provider business mailing address

515 W CENTRAL AVE
WILLIAMSPORT PA
17702-7284
US

V. Phone/Fax

Practice location:
  • Phone: 570-327-1581
  • Fax: 570-326-0641
Mailing address:
  • Phone: 570-327-1581
  • Fax: 570-326-0641

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. MARK E STAMM
Title or Position: DIRECTOR OF SPECIAL EDUCATION
Credential:
Phone: 570-419-7969