Provider Demographics
NPI:1386860880
Name:CLAIRTON CITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:CLAIRTON CITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOUCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-233-7090
Mailing Address - Street 1:502 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:CLAIRTON
Mailing Address - State:PA
Mailing Address - Zip Code:15025-1452
Mailing Address - Country:US
Mailing Address - Phone:412-233-7090
Mailing Address - Fax:412-233-5129
Practice Address - Street 1:502 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:CLAIRTON
Practice Address - State:PA
Practice Address - Zip Code:15025-1452
Practice Address - Country:US
Practice Address - Phone:412-233-7090
Practice Address - Fax:412-233-5129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
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
PA0014605890001Medicaid