Provider Demographics
NPI:1346407277
Name:MILLER SCHOOL DISTRICT 29-4
Entity Type:Organization
Organization Name:MILLER SCHOOL DISTRICT 29-4
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-853-2614
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:623 EAST 4TH STREET
Mailing Address - City:MILLER
Mailing Address - State:SD
Mailing Address - Zip Code:57362-0257
Mailing Address - Country:US
Mailing Address - Phone:605-853-2614
Mailing Address - Fax:
Practice Address - Street 1:623 E 4TH ST
Practice Address - Street 2:
Practice Address - City:MILLER
Practice Address - State:SD
Practice Address - Zip Code:57362-1556
Practice Address - Country:US
Practice Address - Phone:605-853-2614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5152123Medicaid