Provider Demographics
NPI:1659609758
Name:PEMBROKE ELEMENTARY SCHOOL
Entity Type:Organization
Organization Name:PEMBROKE ELEMENTARY SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-853-2567
Mailing Address - Street 1:36 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:ME
Mailing Address - Zip Code:04666-4635
Mailing Address - Country:US
Mailing Address - Phone:207-726-5564
Mailing Address - Fax:207-726-5139
Practice Address - Street 1:36 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:ME
Practice Address - Zip Code:04666-4635
Practice Address - Country:US
Practice Address - Phone:207-726-5564
Practice Address - Fax:207-726-5139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)