Provider Demographics
NPI:1760506448
Name:MCSWAIN UNION ELEMENTARY
Entity Type:Organization
Organization Name:MCSWAIN UNION ELEMENTARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:MOLLART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-723-7877
Mailing Address - Street 1:926 SCOTT RD
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-8893
Mailing Address - Country:US
Mailing Address - Phone:209-723-7877
Mailing Address - Fax:209-723-2267
Practice Address - Street 1:926 SCOTT RD
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8893
Practice Address - Country:US
Practice Address - Phone:209-723-7877
Practice Address - Fax:209-723-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASS2465763Medicaid