Provider Demographics
NPI:1699003640
Name:SCHOOL UNION 107
Entity Type:Organization
Organization Name:SCHOOL UNION 107
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-427-6913
Mailing Address - Street 1:27 BROADWAY
Mailing Address - Street 2:BAILEYVILLE SCHOOL DEPARTMENT
Mailing Address - City:BAILEYVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04694
Mailing Address - Country:US
Mailing Address - Phone:207-427-6913
Mailing Address - Fax:207-427-3166
Practice Address - Street 1:27 BROADWAY
Practice Address - Street 2:BAILEYVILLE SCHOOL DEPARTMENT
Practice Address - City:BAILEYVILLE
Practice Address - State:ME
Practice Address - Zip Code:04694
Practice Address - Country:US
Practice Address - Phone:207-427-6913
Practice Address - Fax:207-427-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME126370000Medicaid