Provider Demographics
NPI:1245381268
Name:CANAJOHARIE CENTRAL SCHOOL
Entity Type:Organization
Organization Name:CANAJOHARIE CENTRAL SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-673-6302
Mailing Address - Street 1:136 SCHOLASTIC WAY
Mailing Address - Street 2:
Mailing Address - City:CANAJOHARIE
Mailing Address - State:NY
Mailing Address - Zip Code:13317-3924
Mailing Address - Country:US
Mailing Address - Phone:518-673-6317
Mailing Address - Fax:518-673-3887
Practice Address - Street 1:136 SCHOLASTIC WAY
Practice Address - Street 2:
Practice Address - City:CANAJOHARIE
Practice Address - State:NY
Practice Address - Zip Code:13317-3924
Practice Address - Country:US
Practice Address - Phone:518-673-6317
Practice Address - Fax:518-673-3887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
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
NY01435125Medicaid