Provider Demographics
NPI:1922298660
Name:EAGLE GROVE COMMUNITY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:EAGLE GROVE COMMUNITY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-448-4749
Mailing Address - Street 1:325 N COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:EAGLE GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:50533-1316
Mailing Address - Country:US
Mailing Address - Phone:515-448-4749
Mailing Address - Fax:515-448-3156
Practice Address - Street 1:325 N COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:EAGLE GROVE
Practice Address - State:IA
Practice Address - Zip Code:50533-1316
Practice Address - Country:US
Practice Address - Phone:515-448-4749
Practice Address - Fax:515-448-3156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA9424145Medicaid