Provider Demographics
NPI:1265480388
Name:DERRY AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:DERRY AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SPECIAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:COPPULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-694-1408
Mailing Address - Street 1:982 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15627-9703
Mailing Address - Country:US
Mailing Address - Phone:724-694-1408
Mailing Address - Fax:724-694-1429
Practice Address - Street 1:982 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:PA
Practice Address - Zip Code:15627-9703
Practice Address - Country:US
Practice Address - Phone:724-694-1408
Practice Address - Fax:724-694-1429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014420520001Medicaid