Provider Demographics
NPI:1225219371
Name:SCHOOL DISTRICT OF FLORENCE COUNTY
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF FLORENCE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUPIL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-528-3309
Mailing Address - Street 1:PO BOX 350
Mailing Address - Street 2:5844 BILL ANDERSON DRIVE
Mailing Address - City:FLORENCE
Mailing Address - State:WI
Mailing Address - Zip Code:54121-0350
Mailing Address - Country:US
Mailing Address - Phone:715-528-3309
Mailing Address - Fax:715-528-5910
Practice Address - Street 1:5844 BILL ANDERSON DRIVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:WI
Practice Address - Zip Code:54121-0350
Practice Address - Country:US
Practice Address - Phone:715-528-3309
Practice Address - Fax:715-528-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44213600Medicaid