=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528117231
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CALAMUS WHEATLAND COMMUNITY SCHOOL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 80 S. 2ND STREET
-----------------------------------------------------
City | CALAMUS
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52729-0158
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-246-2222
-----------------------------------------------------
Fax | 563-246-2221
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 110 E. PARK ROAD P.O. BOX 279
-----------------------------------------------------
City | WHEATLAND
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52777-0279
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 563-374-1292
-----------------------------------------------------
Fax | 563-374-1080
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BOARD SECRETARY TREASURER
-----------------------------------------------------
Name | MS. MARIKA K PEWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 563-374-1292
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------