Provider Demographics
NPI:1912186263
Name:SCHOOL DISTRICT OF FLORENCE COUNTY
Entity Type:Organization
Organization Name:SCHOOL DISTRICT OF FLORENCE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EDYTHE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-528-3217
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:WI
Mailing Address - Zip Code:54121-0440
Mailing Address - Country:US
Mailing Address - Phone:715-528-3217
Mailing Address - Fax:715-528-5338
Practice Address - Street 1:425 OLIVE AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:WI
Practice Address - Zip Code:54121-9421
Practice Address - Country:US
Practice Address - Phone:715-528-3217
Practice Address - Fax:715-528-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44213600Medicaid