Provider Demographics
NPI:1124210935
Name:AVON SCHOOL DISTRICT
Entity Type:Organization
Organization Name:AVON SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-286-3291
Mailing Address - Street 1:210 PINE STREET
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:SD
Mailing Address - Zip Code:57315-0407
Mailing Address - Country:US
Mailing Address - Phone:605-286-3291
Mailing Address - Fax:
Practice Address - Street 1:210 PINE STREET
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:SD
Practice Address - Zip Code:57315-0407
Practice Address - Country:US
Practice Address - Phone:605-286-3291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5150040Medicaid