Provider Demographics
NPI:1891919304
Name:WACHUSETT REGIONAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:WACHUSETT REGIONAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:PANDISCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-829-1670
Mailing Address - Street 1:1745 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:MA
Mailing Address - Zip Code:01522-1102
Mailing Address - Country:US
Mailing Address - Phone:508-829-1670
Mailing Address - Fax:508-829-1679
Practice Address - Street 1:1745 MAIN ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:MA
Practice Address - Zip Code:01522-1102
Practice Address - Country:US
Practice Address - Phone:508-829-1670
Practice Address - Fax:508-829-1679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1950304Medicaid