Provider Demographics
NPI:1053440925
Name:BOZEMAN SCHOOL DISTRICT #7
Entity Type:Organization
Organization Name:BOZEMAN SCHOOL DISTRICT #7
Other - Org Name:SCHOOL DISTRICT RELATED SERVICES - BOZEMAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SUPERINTENDENT OF BUSINES
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-522-6042
Mailing Address - Street 1:404 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4579
Mailing Address - Country:US
Mailing Address - Phone:406-522-6056
Mailing Address - Fax:406-522-6090
Practice Address - Street 1:404 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4579
Practice Address - Country:US
Practice Address - Phone:406-522-6056
Practice Address - Fax:406-522-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0165217Medicaid