Provider Demographics
NPI:1174673461
Name:RICHFIELD SPRINGS CSD
Entity Type:Organization
Organization Name:RICHFIELD SPRINGS CSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:V
Authorized Official - Last Name:SUNDERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-858-0610
Mailing Address - Street 1:PO BOX 631
Mailing Address - Street 2:93 MAIN STREET
Mailing Address - City:RICHFIELD SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13439-0631
Mailing Address - Country:US
Mailing Address - Phone:315-858-0610
Mailing Address - Fax:
Practice Address - Street 1:93 MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13439-4504
Practice Address - Country:US
Practice Address - Phone:315-858-0610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01367353Medicaid