Provider Demographics
NPI:1689018350
Name:MARLBOROUGH SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MARLBOROUGH SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-357-9006
Mailing Address - Street 1:193 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-1602
Mailing Address - Country:US
Mailing Address - Phone:603-357-9006
Mailing Address - Fax:603-357-9066
Practice Address - Street 1:193 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1602
Practice Address - Country:US
Practice Address - Phone:603-357-9006
Practice Address - Fax:603-357-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)