Provider Demographics
NPI:1629360359
Name:RUSH-HENRIETTA CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:RUSH-HENRIETTA CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL NURSE TEACHER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:585-359-5443
Mailing Address - Street 1:133 VOLLMER PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-5127
Mailing Address - Country:US
Mailing Address - Phone:585-359-5443
Mailing Address - Fax:585-359-5453
Practice Address - Street 1:133 VOLLMER PKWY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-5127
Practice Address - Country:US
Practice Address - Phone:585-359-5443
Practice Address - Fax:585-359-5453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01497492Medicaid