Provider Demographics
NPI:1275759854
Name:CONNELLSVILLE AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CONNELLSVILLE AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-628-3300
Mailing Address - Street 1:732 ROCKRIDGE RD.
Mailing Address - Street 2:PO BOX 861
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-0861
Mailing Address - Country:US
Mailing Address - Phone:724-628-3300
Mailing Address - Fax:724-628-6845
Practice Address - Street 1:732 ROCKRIDGE RD.
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-0861
Practice Address - Country:US
Practice Address - Phone:724-628-3300
Practice Address - Fax:724-628-6845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
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
PA0015487590002Medicaid