Provider Demographics
NPI:1073704953
Name:MARKESAN DISTRICT SCHOOLS
Entity Type:Organization
Organization Name:MARKESAN DISTRICT SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-398-2373
Mailing Address - Street 1:100 VISTA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MARKESAN
Mailing Address - State:WI
Mailing Address - Zip Code:53946-0248
Mailing Address - Country:US
Mailing Address - Phone:920-398-2373
Mailing Address - Fax:
Practice Address - Street 1:100 VISTA BOULEVARD
Practice Address - Street 2:
Practice Address - City:MARKESAN
Practice Address - State:WI
Practice Address - Zip Code:53946-0248
Practice Address - Country:US
Practice Address - Phone:920-398-2373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44226500Medicaid