Provider Demographics
NPI:1073792420
Name:SUN PRAIRIE AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SUN PRAIRIE AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CULVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-834-6501
Mailing Address - Street 1:501 S BIRD ST
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2803
Mailing Address - Country:US
Mailing Address - Phone:608-834-6501
Mailing Address - Fax:608-834-6555
Practice Address - Street 1:501 S BIRD ST
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-2803
Practice Address - Country:US
Practice Address - Phone:608-834-6501
Practice Address - Fax:608-834-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4421 6000Medicaid