Provider Demographics
NPI:1598875478
Name:HUTSONVILLE C U SCHOOL DIST 1
Entity Type:Organization
Organization Name:HUTSONVILLE C U SCHOOL DIST 1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:EDDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-563-4912
Mailing Address - Street 1:300 W CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:HUTSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62433-1026
Mailing Address - Country:US
Mailing Address - Phone:618-563-4912
Mailing Address - Fax:
Practice Address - Street 1:300 W CLOVER ST
Practice Address - Street 2:
Practice Address - City:HUTSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62433-1026
Practice Address - Country:US
Practice Address - Phone:618-563-4912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
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
IL=========002Medicaid