Provider Demographics
NPI:1811197916
Name:GLENDALE ELEMENTARY SCHOOL DISTRICT #40
Entity Type:Organization
Organization Name:GLENDALE ELEMENTARY SCHOOL DISTRICT #40
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEPUTY SUPERINTENDANT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEGARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-237-7100
Mailing Address - Street 1:7301 N 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85301-1893
Mailing Address - Country:US
Mailing Address - Phone:623-842-8100
Mailing Address - Fax:623-842-8396
Practice Address - Street 1:7301 N 58TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85301-1893
Practice Address - Country:US
Practice Address - Phone:623-842-8100
Practice Address - Fax:623-842-8396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)