Provider Demographics
NPI:1740460765
Name:JT SCHOOL DIST 2 VILLAGE OF MARSHALL ET AL
Entity type:Organization
Organization Name:JT SCHOOL DIST 2 VILLAGE OF MARSHALL ET AL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-655-3466
Mailing Address - Street 1:617 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:WI
Mailing Address - Zip Code:53559-9273
Mailing Address - Country:US
Mailing Address - Phone:608-655-3466
Mailing Address - Fax:608-655-4481
Practice Address - Street 1:617 MADISON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:WI
Practice Address - Zip Code:53559-9273
Practice Address - Country:US
Practice Address - Phone:608-655-3466
Practice Address - Fax:608-655-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44221100Medicaid