Provider Demographics
NPI:1508817867
Name:GARNET VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:GARNET VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT OF SCHOOLS
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:S
Authorized Official - Last Name:BERTRANDO
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:610-579-7367
Mailing Address - Street 1:80 STATION RD
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1751
Mailing Address - Country:US
Mailing Address - Phone:610-579-7364
Mailing Address - Fax:610-579-7303
Practice Address - Street 1:80 STATION RD
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1751
Practice Address - Country:US
Practice Address - Phone:610-579-7364
Practice Address - Fax:610-579-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018362900001Medicaid