Provider Demographics
NPI:1588795850
Name:CITY OF GARDNER
Entity Type:Organization
Organization Name:CITY OF GARDNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:DARING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-632-1000
Mailing Address - Street 1:70 WATERFORD ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-2525
Mailing Address - Country:US
Mailing Address - Phone:978-632-1000
Mailing Address - Fax:978-630-4047
Practice Address - Street 1:70 WATERFORD ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-2525
Practice Address - Country:US
Practice Address - Phone:978-632-1000
Practice Address - Fax:978-630-4047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1952544Medicaid