Provider Demographics
NPI:1396892782
Name:GREAT FALLS PUBLIC SCHOOLS
Entity type:Organization
Organization Name:GREAT FALLS PUBLIC SCHOOLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR OF BUSINESS
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:VERNON
Authorized Official - Last Name:ODERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-268-6051
Mailing Address - Street 1:1100 4TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4301
Mailing Address - Country:US
Mailing Address - Phone:406-268-6051
Mailing Address - Fax:406-268-6067
Practice Address - Street 1:4040 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1638
Practice Address - Country:US
Practice Address - Phone:406-268-6761
Practice Address - Fax:406-268-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
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
MT161187Medicaid