Provider Demographics
NPI:1861439762
Name:SAINT MARYS AREA SD
Entity Type:Organization
Organization Name:SAINT MARYS AREA SD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:K
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-781-2111
Mailing Address - Street 1:977 S SAINT MARYS ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-2832
Mailing Address - Country:US
Mailing Address - Phone:814-781-2111
Mailing Address - Fax:814-781-2190
Practice Address - Street 1:977 S SAINT MARYS ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-2832
Practice Address - Country:US
Practice Address - Phone:814-781-2109
Practice Address - Fax:814-781-2190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014375170001Medicaid