Provider Demographics
NPI:1114660594
Name:GORDON-RUSHVILLE PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:GORDON-RUSHVILLE PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MEEKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-282-1322
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:GORDON
Mailing Address - State:NE
Mailing Address - Zip Code:69343-0530
Mailing Address - Country:US
Mailing Address - Phone:308-282-1322
Mailing Address - Fax:308-282-2207
Practice Address - Street 1:810 N OAK ST
Practice Address - Street 2:
Practice Address - City:GORDON
Practice Address - State:NE
Practice Address - Zip Code:69343-1044
Practice Address - Country:US
Practice Address - Phone:308-282-1322
Practice Address - Fax:308-282-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026570001Medicaid