Provider Demographics
NPI:1699840702
Name:SCHOOL DISTRICT R 6 SMITHTON
Entity Type:Organization
Organization Name:SCHOOL DISTRICT R 6 SMITHTON
Other - Org Name:SMITHTON R-VI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:660-343-5316
Mailing Address - Street 1:505 S MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTON
Mailing Address - State:MO
Mailing Address - Zip Code:65350-1038
Mailing Address - Country:US
Mailing Address - Phone:660-343-5316
Mailing Address - Fax:
Practice Address - Street 1:505 S MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:SMITHTON
Practice Address - State:MO
Practice Address - Zip Code:65350-1038
Practice Address - Country:US
Practice Address - Phone:660-343-5316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO506087006Medicaid