Provider Demographics
NPI:1154447019
Name:MUSCLE SHOALS CITY
Entity Type:Organization
Organization Name:MUSCLE SHOALS CITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-389-2607
Mailing Address - Street 1:PO BOX 2610
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2610
Mailing Address - Country:US
Mailing Address - Phone:256-389-2607
Mailing Address - Fax:
Practice Address - Street 1:3200 S WILSON DAM RD
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2746
Practice Address - Country:US
Practice Address - Phone:256-389-2607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)