Provider Demographics
NPI:1497805691
Name:EDGEWOOD-COLESBURG COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:EDGEWOOD-COLESBURG COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KLAMFOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-928-6411
Mailing Address - Street 1:PO BOX 316
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:52042-0316
Mailing Address - Country:US
Mailing Address - Phone:563-928-6411
Mailing Address - Fax:563-928-6414
Practice Address - Street 1:403 WEST UNION
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:IA
Practice Address - Zip Code:52042-0316
Practice Address - Country:US
Practice Address - Phone:563-928-6411
Practice Address - Fax:563-928-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0422436Medicaid