Provider Demographics
NPI:1225171655
Name:SUPERINTENDENT OF BISMARCK PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:SUPERINTENDENT OF BISMARCK PUBLIC SCHOOLS
Other - Org Name:BISMARCK SCHOOL DISTRICT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-865-4888
Mailing Address - Street 1:11636 HIGHWAY 84
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:AR
Mailing Address - Zip Code:71929-7473
Mailing Address - Country:US
Mailing Address - Phone:501-865-4506
Mailing Address - Fax:501-865-4545
Practice Address - Street 1:11636 HIGHWAY 84
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:AR
Practice Address - Zip Code:71929-7473
Practice Address - Country:US
Practice Address - Phone:501-865-4506
Practice Address - Fax:501-865-4545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR181845732Medicaid
AR162702761Medicaid
AR127783743Medicaid