Provider Demographics
NPI:1891242327
Name:HITCHCOCK-TULARE SCHOOL
Entity Type:Organization
Organization Name:HITCHCOCK-TULARE SCHOOL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-596-4171
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:401 4TH AVE.
Mailing Address - City:TULARE
Mailing Address - State:SD
Mailing Address - Zip Code:57476
Mailing Address - Country:US
Mailing Address - Phone:605-596-4171
Mailing Address - Fax:605-596-4175
Practice Address - Street 1:401 4TH AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:SD
Practice Address - Zip Code:57476-2125
Practice Address - Country:US
Practice Address - Phone:605-596-4171
Practice Address - Fax:605-596-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty