Provider Demographics
NPI:1255651055
Name:CANNELTON CITY SCHOOL CORP
Entity Type:Organization
Organization Name:CANNELTON CITY SCHOOL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:EMBRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-547-2637
Mailing Address - Street 1:125 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:CANNELTON
Mailing Address - State:IN
Mailing Address - Zip Code:47520-1205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 S 6TH ST
Practice Address - Street 2:
Practice Address - City:CANNELTON
Practice Address - State:IN
Practice Address - Zip Code:47520-1205
Practice Address - Country:US
Practice Address - Phone:812-547-2637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100199770AMedicaid