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General NPI Number Information
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NPI Number | 1487383709
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Entity Type | Organization
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Legal Business Name | CEDAR COUNTY SCHOOL DISTRICT 45
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 06/10/2022
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Provider Practice Location Address
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Address Line | 207 N PIERCE ST
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City | RANDOLPH
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State | NE
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Zip | 68771-5514
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Country | US
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Telephone | 402-337-0252
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Fax | 402-337-0235
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Provider Business Mailing Address
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Address Line | PO BOX 755
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City | RANDOLPH
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State | NE
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Zip | 68771-0755
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Country | US
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Telephone | 402-337-0252
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | TIFFANY J KALIN
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Credential |
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Telephone | 402-337-0252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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