Provider Demographics
NPI:1447391636
Name:UNIFIED SCHOOL DIST NO 353
Entity Type:Organization
Organization Name:UNIFIED SCHOOL DIST NO 353
Other - Org Name:WELLINGTON PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAID CLERK/MIS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-326-4300
Mailing Address - Street 1:221 SOUTH WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67152-3037
Mailing Address - Country:US
Mailing Address - Phone:620-326-4300
Mailing Address - Fax:620-326-4304
Practice Address - Street 1:221 SOUTH WASHINGTON
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:KS
Practice Address - Zip Code:67152-3037
Practice Address - Country:US
Practice Address - Phone:620-326-4300
Practice Address - Fax:620-326-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS052556974OtherTAX ID
KS100324270AMedicaid