Provider Demographics
NPI:1174862494
Name:HAMBURG PUBLIC SCHOOL
Entity Type:Organization
Organization Name:HAMBURG PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:JINKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:CSA
Authorized Official - Phone:973-827-7570
Mailing Address - Street 1:30 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-1120
Mailing Address - Country:US
Mailing Address - Phone:973-827-7570
Mailing Address - Fax:973-827-3624
Practice Address - Street 1:30 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1120
Practice Address - Country:US
Practice Address - Phone:973-827-7570
Practice Address - Fax:973-827-3624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0187411Medicaid