Provider Demographics
NPI:1043365471
Name:BOLIVAR-RICHBURG CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BOLIVAR-RICHBURG CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BILOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-928-2561
Mailing Address - Street 1:100 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:NY
Mailing Address - Zip Code:14715-1235
Mailing Address - Country:US
Mailing Address - Phone:585-928-2561
Mailing Address - Fax:585-928-1368
Practice Address - Street 1:100 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:NY
Practice Address - Zip Code:14715-1235
Practice Address - Country:US
Practice Address - Phone:585-928-2561
Practice Address - Fax:585-928-1368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01368845Medicaid