Provider Demographics
NPI:1093872301
Name:VINTON-SHELLSBURG COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:VINTON-SHELLSBURG COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BARKDOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-436-4728
Mailing Address - Street 1:1502 C AVENUE
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349
Mailing Address - Country:US
Mailing Address - Phone:319-436-4728
Mailing Address - Fax:319-472-3889
Practice Address - Street 1:203 COTTAGE ST NW # C
Practice Address - Street 2:
Practice Address - City:SHELLSBURG
Practice Address - State:IA
Practice Address - Zip Code:52332-9644
Practice Address - Country:US
Practice Address - Phone:319-436-4728
Practice Address - Fax:319-436-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0422113Medicaid