Provider Demographics
NPI:1427380492
Name:USD 333/LCNCK
Entity Type:Organization
Organization Name:USD 333/LCNCK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-243-3518
Mailing Address - Street 1:217 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CONCORDIA
Mailing Address - State:KS
Mailing Address - Zip Code:66901-2803
Mailing Address - Country:US
Mailing Address - Phone:785-243-3518
Mailing Address - Fax:785-243-8883
Practice Address - Street 1:803 VALLEY ST
Practice Address - Street 2:
Practice Address - City:CONCORDIA
Practice Address - State:KS
Practice Address - Zip Code:66901-3621
Practice Address - Country:US
Practice Address - Phone:785-243-3294
Practice Address - Fax:785-243-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100211640EMedicaid