Healthcare Provider Details

I. General information

NPI: 1679898167
Provider Name (Legal Business Name): BISON SCHOOL DISTRICT #52-1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 FIRST AVENUE EAST
BISON SD
57620
US

IV. Provider business mailing address

PO BOX 9 200 EAST CARR STREET
BISON SD
57620-0009
US

V. Phone/Fax

Practice location:
  • Phone: 605-244-5961
  • Fax: 605-244-5276
Mailing address:
  • Phone: 605-244-5961
  • Fax: 605-244-5276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MRS. BONNIE CROW
Title or Position: BUSINESS MANAGER
Credential:
Phone: 605-244-5961