Provider Demographics
NPI:1164620332
Name:CAMPBELL R-2 SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CAMPBELL R-2 SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPT.
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:SUPT
Authorized Official - Phone:573-246-2133
Mailing Address - Street 1:801 S STATE HIGHWAY 53
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:MO
Mailing Address - Zip Code:63933-1367
Mailing Address - Country:US
Mailing Address - Phone:573-246-2133
Mailing Address - Fax:573-246-3212
Practice Address - Street 1:801 S STATE HIGHWAY 53
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:MO
Practice Address - Zip Code:63933-1367
Practice Address - Country:US
Practice Address - Phone:573-246-2133
Practice Address - Fax:573-246-3212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)