Provider Demographics
NPI:1780700062
Name:BURRILLVILLE SCHOOL DEPARTMENT
Entity type:Organization
Organization Name:BURRILLVILLE SCHOOL DEPARTMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMATIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-568-1309
Mailing Address - Street 1:2300 BRONCOS HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02830
Mailing Address - Country:US
Mailing Address - Phone:401-568-1307
Mailing Address - Fax:401-568-1306
Practice Address - Street 1:2220 BRONCOS HWY
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:RI
Practice Address - Zip Code:02830-1628
Practice Address - Country:US
Practice Address - Phone:401-568-1307
Practice Address - Fax:401-568-1306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIBS11487Medicaid