Provider Demographics
NPI:1033204334
Name:COOS COUNTY SCHOOL DISTRICT #13
Entity Type:Organization
Organization Name:COOS COUNTY SCHOOL DISTRICT #13
Other - Org Name:NORTH BEND SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BJ
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLENSTEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-756-8304
Mailing Address - Street 1:1913 MEADE STREET
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459
Mailing Address - Country:US
Mailing Address - Phone:541-756-2521
Mailing Address - Fax:541-756-1313
Practice Address - Street 1:1913 MEADE STREET
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459
Practice Address - Country:US
Practice Address - Phone:541-756-2521
Practice Address - Fax:541-756-1313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR119466Medicaid