Provider Demographics
NPI:1326494261
Name:SPRING GARDEN COMMUNITY CONSOLIDATED SCHOOL DISTRICT #178
Entity Type:Organization
Organization Name:SPRING GARDEN COMMUNITY CONSOLIDATED SCHOOL DISTRICT #178
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-439-7231
Mailing Address - Street 1:14975 E BAKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IL
Mailing Address - Zip Code:62864-7100
Mailing Address - Country:US
Mailing Address - Phone:618-244-8070
Mailing Address - Fax:
Practice Address - Street 1:14975 E BAKERVILLE RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-7100
Practice Address - Country:US
Practice Address - Phone:618-244-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health