Provider Demographics
NPI:1225202948
Name:COLUMBUS SCHOOL DISTRICT
Entity Type:Organization
Organization Name:COLUMBUS SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STUDENT SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-623-5950
Mailing Address - Street 1:200 W SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:WI
Mailing Address - Zip Code:53925-1453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 W SCHOOL ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:WI
Practice Address - Zip Code:53925-1453
Practice Address - Country:US
Practice Address - Phone:920-623-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44221300Medicaid