Provider Demographics
NPI:1851842926
Name:SOUTH SUMMIT SCHOOL DISTRICT
Entity Type:Organization
Organization Name:SOUTH SUMMIT SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-783-4301
Mailing Address - Street 1:285 E 400 S
Mailing Address - Street 2:
Mailing Address - City:KAMAS
Mailing Address - State:UT
Mailing Address - Zip Code:84036-9641
Mailing Address - Country:US
Mailing Address - Phone:435-783-4301
Mailing Address - Fax:435-783-4501
Practice Address - Street 1:285 E 400 S
Practice Address - Street 2:
Practice Address - City:KAMAS
Practice Address - State:UT
Practice Address - Zip Code:84036-9641
Practice Address - Country:US
Practice Address - Phone:435-783-4301
Practice Address - Fax:435-783-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health