Provider Demographics
NPI:1821124694
Name:SWANSEA PUBLIC SCHOOL
Entity Type:Organization
Organization Name:SWANSEA PUBLIC SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBIDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-675-1195
Mailing Address - Street 1:2201 G A R HWY
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3924
Mailing Address - Country:US
Mailing Address - Phone:508-379-1180
Mailing Address - Fax:
Practice Address - Street 1:1 GARDNERS NECK RD
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3239
Practice Address - Country:US
Practice Address - Phone:508-379-1180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1953842Medicaid