Healthcare Provider Details

I. General information

NPI: 1538348362
Provider Name (Legal Business Name): BUTTERNUT SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2007
Last Update Date: 10/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 W WISCONSIN ST
BUTTERNUT WI
54514-9109
US

IV. Provider business mailing address

PO BOX 247
BUTTERNUT WI
54514-0247
US

V. Phone/Fax

Practice location:
  • Phone: 715-769-3434
  • Fax: 715-769-3712
Mailing address:
  • Phone: 715-769-3434
  • Fax: 715-769-3712

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: JIM SCHUCHARDT
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 715-769-3434