Provider Demographics
NPI:1760661466
Name:MERCER SCHOOL DISTRICT
Entity Type:Organization
Organization Name:MERCER SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DISTRICT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-476-2154
Mailing Address - Street 1:2690 W MARGARET ST
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:WI
Mailing Address - Zip Code:54547-9181
Mailing Address - Country:US
Mailing Address - Phone:715-476-2154
Mailing Address - Fax:715-476-2587
Practice Address - Street 1:2690 W MARGARET ST
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:WI
Practice Address - Zip Code:54547-9181
Practice Address - Country:US
Practice Address - Phone:715-476-2154
Practice Address - Fax:715-476-2587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44236900Medicaid