Provider Demographics
NPI:1255382834
Name:EAST ALTON WOOD RIVER HS DIST
Entity type:Organization
Organization Name:EAST ALTON WOOD RIVER HS DIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-254-3151
Mailing Address - Street 1:777 N WOOD RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER
Mailing Address - State:IL
Mailing Address - Zip Code:62095-1227
Mailing Address - Country:US
Mailing Address - Phone:618-254-3151
Mailing Address - Fax:618-254-9113
Practice Address - Street 1:777 N WOOD RIVER AVE
Practice Address - Street 2:
Practice Address - City:WOOD RIVER
Practice Address - State:IL
Practice Address - Zip Code:62095-1227
Practice Address - Country:US
Practice Address - Phone:618-254-3151
Practice Address - Fax:618-254-9113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)