Provider Demographics
NPI:1952448235
Name:PUEBLO COUNTY SCHOOL DIST 70
Entity Type:Organization
Organization Name:PUEBLO COUNTY SCHOOL DIST 70
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-542-1671
Mailing Address - Street 1:24951 E US HIGHWAY 50
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81006-2027
Mailing Address - Country:US
Mailing Address - Phone:719-542-1671
Mailing Address - Fax:719-544-7248
Practice Address - Street 1:24951 E US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81006-2027
Practice Address - Country:US
Practice Address - Phone:719-542-1671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO91751853Medicaid