Provider Demographics
NPI:1275651150
Name:CITY OF SPRINGFIELD
Entity Type:Organization
Organization Name:CITY OF SPRINGFIELD
Other - Org Name:SPRINGFIELD PUBLIC SCHOOLS
Other - Org Type:Other Name
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-787-7056
Mailing Address - Street 1:195 STATE ST
Mailing Address - Street 2:CENTRAL OFFICE
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1704
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:195 STATE ST
Practice Address - Street 2:CENTRAL OFFICE
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1704
Practice Address - Country:US
Practice Address - Phone:413-787-7056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1950045Medicaid