Provider Demographics
NPI:1497806145
Name:LAWTON-BRONSON COMMUNITY SCHOOL
Entity Type:Organization
Organization Name:LAWTON-BRONSON COMMUNITY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE MEDICAID CLAIMS COORDI
Authorized Official - Prefix:
Authorized Official - First Name:BONITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-944-5181
Mailing Address - Street 1:100 TARA WAY
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:IA
Mailing Address - Zip Code:51030-0128
Mailing Address - Country:US
Mailing Address - Phone:712-944-5181
Mailing Address - Fax:712-944-5568
Practice Address - Street 1:100 TARA WAY
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:IA
Practice Address - Zip Code:51030-0128
Practice Address - Country:US
Practice Address - Phone:712-944-5181
Practice Address - Fax:712-944-5568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0422329Medicaid