Provider Demographics
NPI:1225187347
Name:GROTON CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GROTON CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHURTLEFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-898-5301
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-0099
Mailing Address - Country:US
Mailing Address - Phone:607-898-5301
Mailing Address - Fax:607-898-4647
Practice Address - Street 1:516 ELM ST
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1124
Practice Address - Country:US
Practice Address - Phone:607-898-5301
Practice Address - Fax:607-898-4647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01382232Medicaid