Provider Demographics
NPI:1497798128
Name:SOUTH WASCO COUNTY SCHOOL DISTRICT #1
Entity Type:Organization
Organization Name:SOUTH WASCO COUNTY SCHOOL DISTRICT #1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-395-2645
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:MAUPIN
Mailing Address - State:OR
Mailing Address - Zip Code:97037-0346
Mailing Address - Country:US
Mailing Address - Phone:541-395-2645
Mailing Address - Fax:541-395-2679
Practice Address - Street 1:308 DESCHUTES AVE.
Practice Address - Street 2:
Practice Address - City:MAUPIN
Practice Address - State:OR
Practice Address - Zip Code:97037-0346
Practice Address - Country:US
Practice Address - Phone:541-395-2645
Practice Address - Fax:541-395-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORE221643347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR239414Medicaid