Provider Demographics
NPI:1235302886
Name:BOWLER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BOWLER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:G
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-793-4305
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:BOWLER
Mailing Address - State:WI
Mailing Address - Zip Code:54416-0008
Mailing Address - Country:US
Mailing Address - Phone:715-793-4101
Mailing Address - Fax:715-793-1302
Practice Address - Street 1:500 S ALMON ST
Practice Address - Street 2:
Practice Address - City:BOWLER
Practice Address - State:WI
Practice Address - Zip Code:54416-0008
Practice Address - Country:US
Practice Address - Phone:715-793-4101
Practice Address - Fax:715-793-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-03
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44240900Medicaid