Provider Demographics
NPI:1033255682
Name:FULTON CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:FULTON CITY SCHOOL DISTRICT
Other - Org Name:FULTON CITY SCHOOL DISTRICT
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAID COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:GERI
Authorized Official - Middle Name:
Authorized Official - Last Name:GEITNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-593-5547
Mailing Address - Street 1:167 S. 4TH ST.
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-1853
Mailing Address - Country:US
Mailing Address - Phone:315-593-5547
Mailing Address - Fax:315-593-5519
Practice Address - Street 1:167 S. 4TH ST.
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1853
Practice Address - Country:US
Practice Address - Phone:315-593-5547
Practice Address - Fax:315-593-5519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01477132Medicaid