Provider Demographics
NPI:1609197243
Name:NEW SHOREHAM PUBLIC SCHOOLS
Entity Type:Organization
Organization Name:NEW SHOREHAM PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-466-5600
Mailing Address - Street 1:15 HIGH ST
Mailing Address - Street 2:P O BOX 1890
Mailing Address - City:BLOCK ISLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02807
Mailing Address - Country:US
Mailing Address - Phone:401-466-5600
Mailing Address - Fax:401-466-5610
Practice Address - Street 1:15 HIGH ST
Practice Address - Street 2:
Practice Address - City:BLOCK ISLAND
Practice Address - State:RI
Practice Address - Zip Code:02807
Practice Address - Country:US
Practice Address - Phone:401-466-5600
Practice Address - Fax:401-466-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIEDSGMedicaid
RIEDSIMedicaid