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General NPI Number Information
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NPI Number | 1609930502
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Entity Type | Organization
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Legal Business Name | IND SCHOOL DIST 549
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 200 5TH ST SE
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City | PERHAM
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State | MN
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Zip | 56573-1762
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Country | US
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Telephone | 218-346-6500
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Fax | 218-346-6504
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Provider Business Mailing Address
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Address Line | 200 5TH ST SE
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City | PERHAM
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State | MN
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Zip | 56573-1762
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Country | US
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Telephone | 218-346-6500
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Fax | 218-346-6504
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | TAMARA USELMAN
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Credential |
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Telephone | 218-346-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 884625100
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Identifier Type | MEDICAID
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Identifier State | MN
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 884625100
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Identifier Type | MEDICAID
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Identifier State | MN
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Identifier Issuer |
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