Provider Demographics
NPI:1972649119
Name:ANDOVER CENTAL SCHOOL DISTRICT
Entity Type:Organization
Organization Name:ANDOVER CENTAL SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUS. ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-478-8491
Mailing Address - Street 1:31-35 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NY
Mailing Address - Zip Code:14806-0508
Mailing Address - Country:US
Mailing Address - Phone:607-478-8491
Mailing Address - Fax:607-478-8085
Practice Address - Street 1:35 ELM STREET
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:NY
Practice Address - Zip Code:14806-0508
Practice Address - Country:US
Practice Address - Phone:607-478-8491
Practice Address - Fax:607-478-8085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01402726Medicaid