Provider Demographics
NPI:1790842649
Name:GANANDA CENTRAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GANANDA CENTRAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-986-3521
Mailing Address - Street 1:PO BOX 609
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-0609
Mailing Address - Country:US
Mailing Address - Phone:315-986-3521
Mailing Address - Fax:315-986-2003
Practice Address - Street 1:1500 DAYSPRING RDG
Practice Address - Street 2:
Practice Address - City:WALWORTH
Practice Address - State:NY
Practice Address - Zip Code:14568-9517
Practice Address - Country:US
Practice Address - Phone:315-986-3521
Practice Address - Fax:315-986-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01411738Medicaid