=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235318007
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SCHOOL DISTRICT OF REEDSBURG
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/30/2007
-----------------------------------------------------
Last Update Date | 10/30/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501 K ST
-----------------------------------------------------
City | REEDSBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53959-1825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-524-2174
-----------------------------------------------------
Fax | 608-524-6818
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501 K ST
-----------------------------------------------------
City | REEDSBURG
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53959-1825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-524-2174
-----------------------------------------------------
Fax | 608-524-6818
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PUPIL SERVICES
-----------------------------------------------------
Name | MR. DAVID P. PERRODIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 608-524-2174
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------