Provider Demographics
NPI:1417136524
Name:BUCKEYE UNION HIGH SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BUCKEYE UNION HIGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FEDERAL FUNDS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-327-2284
Mailing Address - Street 1:902 E EASON AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-2602
Mailing Address - Country:US
Mailing Address - Phone:623-327-2284
Mailing Address - Fax:623-386-9705
Practice Address - Street 1:902 E EASON AVE
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-2602
Practice Address - Country:US
Practice Address - Phone:623-327-2284
Practice Address - Fax:623-386-9705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ576481Medicaid