Provider Demographics
NPI:1043359755
Name:BROCKPORT CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BROCKPORT CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JILL REICHHART
Authorized Official - Middle Name:A
Authorized Official - Last Name:REICHHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-637-1824
Mailing Address - Street 1:40 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-2228
Mailing Address - Country:US
Mailing Address - Phone:585-637-1824
Mailing Address - Fax:585-637-1829
Practice Address - Street 1:40 ALLEN ST
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-2228
Practice Address - Country:US
Practice Address - Phone:585-637-1824
Practice Address - Fax:585-637-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01476526Medicaid