Provider Demographics
NPI:1518148659
Name:BURLINGTON AREA SCHOOL DISTRICT
Entity Type:Organization
Organization Name:BURLINGTON AREA SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SMET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-763-0214
Mailing Address - Street 1:100 N KANE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1842
Mailing Address - Country:US
Mailing Address - Phone:262-763-0210
Mailing Address - Fax:262-763-0215
Practice Address - Street 1:100 N KANE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1842
Practice Address - Country:US
Practice Address - Phone:262-763-0210
Practice Address - Fax:262-763-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44207200Medicaid